FDA Adverse Event Malfunction Summary report: N

FLEXTEND

MDR report key: 1946163 · Received January 4, 2011

Report

Report Number
2124215-2010-20905
Event Type
Malfunction
Date Received
January 4, 2011
Date of Event
September 22, 2010
Report Date
October 14, 2010
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE LEAD REMAINS IMPLANTED. NO ADDITIONAL INFORMATION IS AVAILABLE AT THIS TIME. IF ADDITIONAL INFORMATION BECOMES AVAILABLE, THIS REPORT WILL BE UPDATED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS RIGHT ATRIAL LEAD DISPLAYED HIGH IMPEDANCE MEASUREMENTS ONE DAY AFTER THE DEVICE REPLACEMENT PROCEDURE. ANOTHER MANUFACTURES FIELD REPRESENTATIVE PERFORMED TESTING AND COULD NOT REPRODUCE THE HIGH IMPEDANCE MEASUREMENT. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FLEXTEND IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4087

Patients

Seq Age Sex Outcome Treatment
1 60 YR MISMATCH| H175| 4518| 4087| 0158