FDA Adverse Event Injury Summary report: N

ENRHYTHM DR

MDR report key: 1925324 · Received December 14, 2010

Report

Report Number
6000144-2010-06290
Event Type
Injury
Date Received
December 14, 2010
Manufacturer
MEDTRONIC MED REL, INC.
Product Code
DXY
PMA / PMN Number
P980035/S38
Removal / Correction Number
ASKU
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. THE DEVICE IS PART OF THE ADVISORY FOR THIS MODEL. EVALUATION SUMMARY: (B)(4) THE ACTUAL DEVICE WAS NOT RECEIVED FOR EVALUATION. THE PERFORMANCE DATA COLLECTED FROM THE DEVICE WAS ANALYZED AND REVEALED "LOW TELEMETERED BATTERY VOLTAGE". ON (B)(6) 2010, THE TELEMETERED BATTERY VOLTAGE WAS 2.81 V, WHILE THE DAILY BATTERY VOLTAGE TREND MEASUREMENT WAS 2.96 V. THIS DIFFERENCE IS RIGHT AT THE LIMIT OF THE EXPECTED RANGE (<150 MV).

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. THE DEVICE IS PART OF THE ADVISORY FOR THIS MODEL.

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. THE DEVICE IS PART OF THE ADVISORY FOR THIS MODEL. EVALUATION SUMMARY: (B)(4) THE PERFORMANCE DATA COLLECTED FROM THE DEVICE WAS ANALYZED AND REVEALED "LOW TELEMETERED BATTERY VOLTAGE". ON (B)(6) 2010, THE TELEMETERED BATTERY VOLTAGE WAS 2.81 V, WHILE THE DAILY BATTERY VOLTAGE TREND MEASUREMENT WAS 2.96 V. THIS DIFFERENCE IS RIGHT AT THE LIMIT OF THE EXPECTED RANGE (<150 MV). THE DEVICE WAS ALSO RETURNED AND ANALYZED. HIGH BATTERY IMPEDANCE CAUSED THE ELECTIVE REPLACEMENT INDICATOR (ERI) TO TRIGGER.

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. THE DEVICE IS PART OF THE ADVISORY FOR THIS MODEL. ANALYSIS OF THE DEVICE IS IN PROCESS; THE RESULTS WILL BE FORWARDED WHEN AVAILABLE. EVALUATION SUMMARY: (B)(4) THE PERFORMANCE DATA COLLECTED FROM THE DEVICE WAS ANALYZED AND REVEALED "LOW TELEMETERED BATTERY VOLTAGE". ON (B)(6) 2010, THE TELEMETERED BATTERY VOLTAGE WAS 2.81 V, WHILE THE DAILY BATTERY VOLTAGE TREND MEASUREMENT WAS 2.96 V. THIS DIFFERENCE IS RIGHT AT THE LIMIT OF THE EXPECTED RANGE (<150 MV).

Description of Event or Problem · 1

IT WAS REPORTED THAT AT A DEVICE CHECK, THE DEVICE BATTERY VOLTAGE WAS 2.59 VOLTS, AND ONE MONTH LATER IT WAS 2.81 VOLTS. THE DEVICE REMAINS IN USE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT AT A DEVICE CHECK, THE DEVICE BATTERY VOLTAGE WAS 2.59 VOLTS, AND ONE MONTH LATER IT WAS 2.81 VOLTS. THE DEVICE REMAINS IN USE. IT WAS FURTHER REPORTED THAT THE DEVICE WAS AT ELECTIVE REPLACEMENT INDICATOR (ERI) PRIOR TO FIVE YEARS. THE DEVICE WAS EXPLANTED AND REPLACED. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT AT A DEVICE CHECK, THE DEVICE BATTERY VOLTAGE WAS 2.59 VOLTS, AND ONE MONTH LATER IT WAS 2.81 VOLTS. THE DEVICE REMAINS IN USE. IT WAS FURTHER REPORTED THAT THE DEVICE WAS AT ELECTIVE REPLACEMENT INDICATOR (ERI) PRIOR TO FIVE YEARS. THE DEVICE WAS EXPLANTED AND REPLACED. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENRHYTHM DR IMPLANTABLE PULSE GENERATOR DXY MEDTRONIC MED REL, INC. P1501DR ASKU

Patients

Seq Age Sex Outcome Treatment
1 71 YR Hospitalization| O| R (B)(4) IMPLANTABLE PACING LEAD| (B)(4) IMPLANTABLE PACING LEAD| (B)(4) IMPLANTABLE PACING LEAD| (B)(4) IMPLANTABLE PACING LEAD