FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 1952744 · Received January 7, 2011

Report

Report Number
2124215-2010-23778
Event Type
Injury
Date Received
January 7, 2011
Date of Event
December 8, 2009
Report Date
December 3, 2010
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

OUR RECORDS INDICATE THAT THIS LEAD REMAINS IMPLANTED. IF ADDITIONAL INFORMATION IS RECEIVED, THIS REPORT WILL BE UPDATED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC CRM RECEIVED INFORMATION THAT THIS RIGHT ATRIAL (RA) LEAD EXHIBITED HIGH PACING IMPEDANCE MEASUREMENTS GREATER THAN 2000 OHMS. TECHNICAL SERVICES (TS) DISCUSSED PERFORMING ISOMETRICS AND POCKET MANIPULATION AS WELL AS AN X-RAY TO DETERMINE THE CAUSE OF THIS ISSUE. NO ADVERSE PATIENT EFFECTS WERE REPORTED. ADDITIONAL INFORMATION INDICATED THAT A REVISION PROCEDURE WAS PERFORMED AND THIS LEAD WAS SURGICALLY CAPPED. THERE WAS NO VISABLE FRACTURE OR INTERITY BREAKDOWN NOTED ON FLUOROSCOPY.

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 76 YR 1861| 0148| 4470| E110