BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ACCENT DR RF

    MDR report key: 2014141 · Received March 10, 2011

    Report

    Report Number
    2017865-2011-01830
    Event Type
    Malfunction
    Date Received
    March 10, 2011
    Date of Event
    January 17, 2011
    Manufacturer
    ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
    Product Code
    DXY
    PMA / PMN Number
    NA
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT VENTRICULAR UNDERSENSING BY THE PULSE GENERATOR CAUSED THE PATIENT TO GO INTO VENTRICULAR TACHYCARDIA WHICH SUBSEQUENTLY SELF TERMINATED. THE PATIENT'S R-WAVES WERE BETWEEN 2-3 MV. THE VENTRICULAR SENSITIVITY SETTINGS WERE INCREASED AND THE PATIENT WOULD BE MONITORED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ACCENT DR RF IMPLANTABLE PACEMAKER PULSE GENERATOR DXY ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION PM2210 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 70 YR