FDA Adverse Event Injury Summary report: N

ENRHYTHM DR

MDR report key: 1991253 · Received February 15, 2011

Report

Report Number
6000144-2011-00854
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
PA, US
Reporter Occupation
PHYSICIAN

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. THE DEVICE IS PART OF THE ADVISORY FOR THIS MODEL. EVALUATION SUMMARY: (B)(4) THE BATTERY TELEMETERED VALUE MEASURED 2.81 VOLTS AND THE 2.31 VOLTS LOADED. THE INCORRECT RECOMMENDED REPLACEMENT TIME BATTERY VOLTAGE MEASUREMENTS ARE THE RESULT OF HIGH INTERNAL BATTERY IMPEDANCE.

Additional Manufacturer Narrative · 1

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

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE ELECTIVE REPLACEMENT INDICATOR WAS TRIGGERED PREMATURELY, DUE TO HIGH BATTERY IMPEDANCE MEASUREMENTS. THE DEVICE WAS EXPLANTED AND REPLACED. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

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| R 4058M IMPLANTABLE PACING LEAD| 4524 IMPLANTABLE PACING LEAD| 4058M IMPLANTABLE PACING LEAD| 4524 IMPLANTABLE PACING LEAD