FDA Adverse Event Malfunction Summary report: N

CONTAK RENEWAL

MDR report key: 1954156 · Received January 10, 2011

Report

Report Number
2124215-2010-23893
Event Type
Malfunction
Date Received
January 10, 2011
Date of Event
December 13, 2010
Report Date
December 15, 2010
Manufacturer
GUIDANT CRM CLONMEL IRELAND
Product Code
NIK
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

UPON RECEIPT AT OUR POST-MARKET QUALITY ASSURANCE LABORATORY, A LONGEVITY CALCULATION CONFIRMED THAT THE DEVICE DID NOT MEET LONGEVITY ESTIMATES PROVIDED IN DEVICE LABELING. PORTIONS OF THE CIRCUITRY, INCLUDING THE BATTERY, WERE ISOLATED AND TESTED. FINAL ANALYSIS CONCLUDED THAT THE PREMATURE BATTERY DEPLETION WAS DUE TO LOW-VOLTAGE CAPACITOR DEGRADATION, WHICH RESULTED IN A HIGH CURRENT CONDITION.

Additional Manufacturer Narrative · 1

DETAILED ANALYSIS IS PENDING.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS CARDIAC RESYNCHRONIZATION THERAPY DEFIBRILLATOR (CRT-D) WAS EXPLANTED DUE TO NORMAL BATTERY DEPLETION. HOWEVER, INITIAL ANALYSIS REVEALED A DEVICE ANOMALY. NO ADVERSE PATIENT EFFECTS WERE REPORTED. THIS DEVICE IS INCLUDED IN THE SHORTENED REPLACEMENT WINDOW ADVISORY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CONTAK RENEWAL IMPLANTABLE CHF GENERATOR NIK GUIDANT CRM CLONMEL IRELAND H179

Patients

Seq Age Sex Outcome Treatment
1 73 YR 1298| H179| 1170| E102| 0158| 1130| 4261| 4513