FDA Adverse Event Injury Summary report: N

PARADYM

MDR report key: 1971465 · Received January 21, 2011

Report

Report Number
1000165971-2011-00033
Event Type
Injury
Date Received
January 21, 2011
Date of Event
January 4, 2011
Report Date
January 6, 2011
Manufacturer
SORIN BIOMEDICA C.R.M., S.R.L.
Product Code
MRM
PMA / PMN Number
P980049
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4) 2011. THIS EVENT CONCERNS A DEVICE THAT WAS MANUFACTURED AND USED OUTSIDE THE UNITED STATES. ANALYSIS IS PENDING.

Description of Event or Problem · 1

THE DEVICE WAS IMPLANTED ON (B)(6) 2010 AND AN ISOLINE LEAD WAS CONNECTED TO THE ICD (B)(4). REPORTEDLY, THE PATIENT WAS ADMITTED TO THE HOSPITAL BECAUSE HE RECEIVED 80 SHOCKS THERAPY. PRELIMINARY ANALYSIS REVEALED THAT THE PATTERN OF MOST OF THE RECORDED EPISODES CLEARLY SUGGESTED A LEAD ISSUE (DISLODGEMENT, INSULATION FAILURE, CONDUCTOR FRACTURE). BECAUSE OF THE HIGH FREQUENCY OF THIS PHENOMENON, EVALUATION OF A RE-INTERVENTION WAS RECOMMENDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PARADYM MRM SORIN BIOMEDICA C.R.M., S.R.L. PARADYM DR 8550 2400

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention