FDA Adverse Event Injury Summary report: N

ENRHYTHM DR

MDR report key: 1991079 · Received February 15, 2011

Report

Report Number
6000144-2011-00825
Event Type
Injury
Date Received
February 15, 2011
Manufacturer
MEDTRONIC MED REL, INC.
Product Code
DXY
PMA / PMN Number
P980035/S38
Removal / Correction Number
Z-1440-2010
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. EVALUATION SUMMARY: (B)(4) CALCULATIONS BASED ON IMPLANT PARAMETERS INDICATE THAT THE DEVICE HAD MET ITS 99.9% EXPECTED LONGEVITY. ANALYSIS OF THE DEVICE MEMORY FOUND THE ERI (ELECTIVE REPLACEMENT INDICATOR) IS THE RESULT OF HIGH INTERNAL BATTERY RESISTANCE. THIS DEVICE IS PART OF THE FIELD ACTION AND HAS TESTED CONSISTENT WITH THE FIELD ACTION.

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. ANALYSIS OF THE DEVICE IS IN PROCESS; THE RESULTS WILL BE FORWARDED WHEN AVAILABLE.

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THERE WERE INCONGRUENCE'S WITH THE PROJECTED DEVICE LONGEVITY. THE DEVICE REMAINS IN USE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT. IT WAS FURTHER REPORTED THAT THE DEVICE WAS EXPLANTED AND RETURNED TO THE MANUFACTURER. IT WAS REPORTED THAT THERE WERE INCONGRUENCE'S WITH THE PROJECTED DEVICE LONGEVITY. THE DEVICE REMAINS IN USE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT. (B)(6) 2011 IT WAS FURTHER REPORTED THAT THE DEVICE WAS EXPLANTED AND RETURNED TO THE MANUFACTURER.

Description of Event or Problem · 1

IT WAS REPORTED THAT THERE WERE INCONGRUENCE'S WITH THE PROJECTED DEVICE LONGEVITY. THE DEVICE REMAINS IN USE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT THERE WERE INCONGRUENCE'S WITH THE PROJECTED DEVICE LONGEVITY. THE DEVICE REMAINS IN USE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT. IT WAS FURTHER REPORTED THAT THE DEVICE WAS EXPLANTED AND RETURNED TO THE MANUFACTURER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENRHYTHM DR IMPLANTABLE PULSE GENERATOR DXY MEDTRONIC MED REL, INC. P1501DR ASKU

Patients

Seq Age Sex Outcome Treatment
1 86 YR Hospitalization| O| R 4092 IMPLANTABLE PACING LEAD| 4592 IMPLANTABLE PACING LEAD| 4092 IMPLANTABLE PACING LEAD| 4592 IMPLANTABLE PACING LEAD| 4092 IMPLANTABLE PACING LEAD| 4592 IMPLANTABLE PACING LEAD