FDA Adverse Event Malfunction Summary report: N

CURRENT PLUS DR, DF-4 CONNECTOR

MDR report key: 1954752 · Received January 10, 2011

Report

Report Number
2017865-2011-00474
Event Type
Malfunction
Date Received
January 10, 2011
Date of Event
October 4, 2010
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
LWS
PMA / PMN Number
P910023
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED. RELIABILITY LABORATORY TECHNICIAN (B)(4) - FAILURE (EVENT) OBSERVED DURING ANALYSIS FOUND THE DEVICE WITH PREMATURE BATTERY DEPLETION. THE DEVICE WAS ANALYZED WITH A NEW BATTERY AND FOUND TO BE NORMAL. THE ORIGINAL BATTERY WAS SENT OUT TO THE VENDOR FOR FURTHER EVALUATION, AND NO ANOMALY WAS DETECTED THAT WOULD CAUSE THE BATTERY TO DEPLETE. THE CAUSE FOR THE PREMATURE BATTERY DEPLETION COULD NOT BE DETERMINED.

Description of Event or Problem · 1

THIS REPORT IS TO ADVISE OF AN EVENT OBSERVED DURING ANALYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CURRENT PLUS DR, DF-4 CONNECTOR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION CD2211-36Q NA

Patients

Seq Age Sex Outcome Treatment
1