FDA Adverse Event Injury Summary report: N

EMBLEM S-ICD

MDR report key: 20251994 · Received September 18, 2024

Report

Report Number
2124215-2024-58464
Event Type
Injury
Date Received
September 18, 2024
Date of Event
October 1, 2020
Report Date
December 17, 2024
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
LWS
PMA / PMN Number
P110042/S077
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE RETURNED ELECTRODE WAS THOROUGHLY INSPECTED AND ANALYZED. RESISTANCE TESTS WERE COMPLETED TO ASSESS ELECTRICAL PERFORMANCE AND INNER INSULATION INTEGRITY. MEASUREMENTS THROUGHOUT THESE TESTS WERE WITHIN NORMAL LIMITS. MICROSCOPIC INSPECTIONS OF THE TERMINAL PIN ASSEMBLY AND ELECTRODE BODY FOUND NO ANOMALIES. LABORATORY ANALYSIS DID NOT IDENTIFY ANY ELECTRODE CHARACTERISTICS THAT WOULD HAVE CAUSED OR CONTRIBUTED TO THE REPORTED CLINICAL OBSERVATIONS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS ELECTRODE AND SUBCUTANEOUS IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (S-ICD) EXHIBITED INCREASED SHOCK IMPEDANCE MEASUREMENTS FROM THE 77-92 OHMS RANGE AT IMPLANT, TO THE 120-150 OHMS RANGE BEGINNING APPROXIMATELY FOUR MONTHS POST IMPLANT. MEASUREMENTS REMAINED WITHIN THE 120-150 OHMS RANGE EVER SINCE. ADDITIONAL INFORMATION WAS RECEIVED SHOCK IMPEDANCE MEASUREMENTS CONTINUED TO INCREASE TO THE 200-216 OHMS RANGE. SURGICAL INTERVENTION WAS UNDERTAKEN. THE DEVICE AND ELECTRODE WERE EXPLANTED AND REPLACED. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED. THE RETURN OF THE PRODUCT HAS BEEN REQUESTED. THIS REPORT WILL BE UPDATED UPON RETURN AND COMPLETION OF ANALYSIS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS ELECTRODE AND SUBCUTANEOUS IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (S-ICD) EXHIBITED INCREASED SHOCK IMPEDANCE MEASUREMENTS FROM THE 77-92 OHMS RANGE AT IMPLANT, TO THE 120-150 OHMS RANGE BEGINNING APPROXIMATELY FOUR MONTHS POST IMPLANT. MEASUREMENTS REMAINED WITHIN THE 120-150 OHMS RANGE EVER SINCE. ADDITIONAL INFORMATION WAS RECEIVED SHOCK IMPEDANCE MEASUREMENTS CONTINUED TO INCREASE TO THE 200-216 OHMS RANGE. SURGICAL INTERVENTION WAS UNDERTAKEN. THE DEVICE AND ELECTRODE WERE EXPLANTED AND REPLACED. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED. THE RETURN OF THE PRODUCT HAS BEEN REQUESTED. THIS REPORT WILL BE UPDATED UPON RETURN AND COMPLETION OF ANALYSIS. ADDITIONAL INFORMATION WAS RECEIVED THAT THE ROOT CAUSE OF THE HIGH SHOCK IMPEDANCE MEASUREMENTS WAS FELT TO BE DUE TO FAT BETWEEN THE ELECTRODE COIL AND THE STERNUM. THE PRODUCT HAS BEEN RECEIVED FOR ANALYSIS. THIS REPORT WILL BE UPDATED UPON COMPLETION OF ANALYSIS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS ELECTRODE AND SUBCUTANEOUS IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (S-ICD) EXHIBITED INCREASED SHOCK IMPEDANCE MEASUREMENTS FROM THE 77-92 OHMS RANGE AT IMPLANT, TO THE 120-150 OHMS RANGE BEGINNING APPROXIMATELY FOUR MONTHS POST IMPLANT. MEASUREMENTS REMAINED WITHIN THE 120-150 OHMS RANGE EVER SINCE. ADDITIONAL INFORMATION WAS RECEIVED SHOCK IMPEDANCE MEASUREMENTS CONTINUED TO INCREASE TO THE 200-216 OHMS RANGE. SURGICAL INTERVENTION WAS UNDERTAKEN. THE DEVICE AND ELECTRODE WERE EXPLANTED AND REPLACED. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED. THE RETURN OF THE PRODUCT HAS BEEN REQUESTED. THIS REPORT WILL BE UPDATED UPON RETURN AND COMPLETION OF ANALYSIS. ADDITIONAL INFORMATION WAS RECEIVED THAT THE ROOT CAUSE OF THE HIGH SHOCK IMPEDANCE MEASUREMENTS WAS FELT TO BE DUE TO FAT BETWEEN THE ELECTRODE COIL AND THE STERNUM. THE PRODUCT HAS BEEN RECEIVED FOR ANALYSIS. THIS REPORT WILL BE UPDATED UPON COMPLETION OF ANALYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2532749 EMBLEM S-ICD IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (NON-CRT) LWS BOSTON SCIENTIFIC CORPORATION 3501 163778

Patients

Seq Age Sex Outcome Treatment
1 37 YR Female Required Intervention| H