FDA Adverse Event Injury Summary report: N

SOLETRA

MDR report key: 2000273 · Received February 17, 2011

Report

Report Number
9614453-2011-01176
Event Type
Injury
Date Received
February 17, 2011
Date of Event
January 24, 2011
Report Date
January 27, 2011
Manufacturer
MEDTRONIC EUROPE SARL
Product Code
MHY
PMA / PMN Number
P960009
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

RECEIVED INFORMATION THE PATIENT NOTICED A RETURN OF HER TREMORS AND WHEN THE DEVICE WAS CHECKED NO TELEMETRY COULD BE TAKEN. THE IPG WAS REPLACED TWO YEARS AFTER IMPLANT. HCP SUSPECTED EARLY BATTERY DEPLETION. LEADS AND EXTENSIONS WERE NOT REPLACED. OUTPUT SETTINGS BEFORE EXPLANT: 2.9V, 90PW, 135HZM 1 (-), 2(-), 3(+). OUTPUT SETTINGS AFTER REPLACEMENT: 1.6VM 90PW, 135HX, 2(-), CAN TELEMETRY WAS TAKEN AFTER REPLACEMENT, IT SHOWED 0&2: OVER 2000 OHMS, 1&3: BELOW 50 OHMS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SOLETRA MHY MEDTRONIC EUROPE SARL 7426 NA

Patients

Seq Age Sex Outcome Treatment
1 52 YR Required Intervention EXTENSION: MODEL 7482, LOT# NHU190257V| EXTENSION: MODEL 7482A51, LOT# NHU196694V| LEAD: MODEL 3387, LOT# V208201| IMPLANTED:| EXPLANTED:| IMPLANTED:| LEAD: MODEL 3387, LOT# V204738| EXPLANTED:| EXPLANTED:| IMPLANTED:| IMPLANTED:| EXPLANTED: