FDA Adverse Event Malfunction Summary report: N

ENRHYTHM DR

MDR report key: 1925848 · Received December 14, 2010

Report

Report Number
6000144-2010-06354
Event Type
Malfunction
Date Received
December 14, 2010
Date of Event
October 4, 2010
Manufacturer
MEDTRONIC MED REL, INC.
Product Code
DXY
PMA / PMN Number
P980035/S38
Removal / Correction Number
ASKU
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

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. WE DID RECEIVE PERFORMANCE DATA COLLECTED FROM THE DEVICE AND HAVE ANALYZED THE DATA. ANALYSIS CONCLUDED THAT NO ANOMALIES COULD BE FOUND. ON (B)(6) 2010, THE TELEMETERED BATTERY VOLTAGE WAS 2.78 V WHILE THE DAILY BATTERY VOLTAGE TREND MEASUREMENT WAS 2.89 V. THIS DIFFERENCE IS WITHIN EXPECTATIONS.

Description of Event or Problem · 1

IT WAS REPORTED THAT ON INTERROGATION IN CLINIC THE BATTERY GAVE LOW READINGS AND DIFFERENT READINGS THAN AT A PREVIOUS INTERROGATION THAT DAY. BATTERY MEASUREMENTS WERE SENT TO THE CALLER. THE DEVICE REMAINS IN USE. NO PATIENT COMPLICATIONS WERE 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 60 YR Other 5554 IMPLANTABLE PACING LEAD| 5054 IMPLANTABLE PACING LEAD