FDA Adverse Event Injury Summary report: N

ENRHYTHM DR

MDR report key: 1991867 · Received February 15, 2011

Report

Report Number
6000094-2011-00292
Event Type
Injury
Date Received
February 15, 2011
Manufacturer
MEDTRONIC S.A.
Product Code
DXY
PMA / PMN Number
P980035/S38
Removal / Correction Number
ASKU
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS EVENT OCCURRED OUTSIDE THE US. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. PATIENT INFORMATION IS NOT GENERALLY AVAILABLE DUE TO CONFIDENTIALITY CONCERNS. EVALUATION SUMMARY: (B)(4) ANALYSIS OF THE DEVICE REVEALED HIGH BATTERY IMPEDANCE. WE DID RECEIVE PERFORMANCE DATA COLLECTED FROM THE DEVICE AND HAVE ANALYZED THE DATA. ERI DUE TO HIGH BATTERY IMPEDANCE WAS TRIGGERED ON (B)(6) 2010, PRIOR TO EXPLANT.

Additional Manufacturer Narrative · 1

THIS EVENT OCCURRED OUTSIDE THE US. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. PATIENT INFORMATION IS NOT GENERALLY AVAILABLE DUE TO CONFIDENTIALITY CONCERNS. 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 ELECTIVE REPLACEMENT INDICATOR (ERI) TRIGGERED THREE WEEKS AFTER DEVICE CHECK, POSSIBLY DUE TO PREMATURE BATTERY DEPLETION. THE DEVICE WAS EXPLANTED AND REPLACED WITH A NEW DEVICE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Description of Event or Problem · 1

ASKU

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENRHYTHM DR IMPLANTABLE PULSE GENERATOR DXY MEDTRONIC S.A. P1501DR ASKU

Patients

Seq Age Sex Outcome Treatment
1 86 YR Hospitalization| R