FDA Adverse Event Malfunction Summary report: N

VITALITY 2

MDR report key: 1952149 · Received January 7, 2011

Report

Report Number
2124215-2010-23555
Event Type
Malfunction
Date Received
January 7, 2011
Date of Event
December 2, 2010
Report Date
December 2, 2010
Manufacturer
GUIDANT CRM CLONMEL IRELAND
Product Code
LWS
Removal / Correction Number
Z-1513-08 TO Z-1514-08
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

A REVIEW OF DEVICE MEMORY REVEALED THAT THE DEVICE DECLARED ELECTIVE REPLACEMENT INDICATOR (ERI) AFTER EXPERIENCING TWO CONSECUTIVE CHARGE TIMES GREATER THAN THE EXTENDED MID-LIFE ERI CHARGE TIME LIMIT. THE OBSERVED RATE OF BATTERY USAGE WAS COMPARED TO THE EXPECTED RATE OF BATTERY USAGE; THE RESULTS INDICATED THAT THE MONITORING VOLTAGE WAS NORMAL. ALTHOUGH THE BATTERY ITSELF HAD NOT DEPLETED PREMATURELY, ERI WAS TRIGGERED EARLIER THAN EXPECTED BY EXTENDED CHARGE TIMES DUE TO A HIGHER-THAN-TYPICAL BUILD-UP OF INTERNAL BATTERY IMPEDANCE. THIS DEVICE IS INCLUDED IN THE MID-LIFE DISPLAY OF REPLACEMENT INDICATORS ADVISORY POPULATION.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS IMPLANTABLE CARDIOVERTER DEFIBRILLATOR WAS REMOVED AND RETURNED FOR AN UNSPECIFIED REASON. ROUTINE DEVICE ANALYSIS TESTING REVEALED THE DEVICE DECLARED THE ELECTIVE REPLACEMENT INDICATOR WHILE IMPLANTED. THE DEVICE FAILED THE INITIAL LONGEVITY CALCULATION. A REVIEW OF THE BATTERY LOG REVEALED A PATTERN OF INCREASING CHARGE TIMES. THE DEVICE WAS FORWARDED ON FOR FURTHER DETAILED ANALYSIS TESTING. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VITALITY 2 IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS GUIDANT CRM CLONMEL IRELAND T167

Patients

Seq Age Sex Outcome Treatment
1 Other