FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 1944946 · Received January 3, 2011

Report

Report Number
2124215-2010-20259
Event Type
Injury
Date Received
January 3, 2011
Date of Event
October 5, 2010
Report Date
October 5, 2010
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

DUE TO THE NATURE OF THE ISSUE, NO ANALYSIS WILL BE CONDUCTED IF THE PRODUCT IS RETURNED. THIS REPORT WILL BE UPDATED IF ADDITIONAL INFORMATION IS RECEIVED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC CRM RECEIVED INFORMATION THAT THIS PRODUCT WAS PART OF A SYSTEM EXPLANT DUE TO A PATIENT INFECTION. THERE WAS NO REPORT OF ADVERSE PATIENT EFFECTS DUE TO THE EXPLANT PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4470

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention