FDA Adverse Event Injury Summary report: N

VITALITY 2

MDR report key: 2040999 · Received April 6, 2011

Report

Report Number
2124215-2011-01738
Event Type
Injury
Date Received
April 6, 2011
Date of Event
January 10, 2011
Report Date
January 10, 2011
Manufacturer
GUIDANT CRM CLONMEL IRELAND
Product Code
LWS
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

UPON RECEIPT AT OUR POST-MARKET QUALITY ASSURANCE LABORATORY, A LONGEVITY CALCULATION CONFIRMED THAT THE DEVICE DID NOT MEET LONGEVITY ESTIMATES PROVIDED IN DEVICE LABELING. PORTIONS OF THE CIRCUITRY, INCLUDING THE BATTERY, WERE ISOLATED AND TESTED. FINAL ANALYSIS CONCLUDED THAT THE PREMATURE BATTERY DEPLETION WAS DUE TO LOW-VOLTAGE CAPACITOR DEGRADATION, WHICH RESULTED IN A HIGH CURRENT CONDITION.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS DEVICE HAD REACHED ELECTIVE REPLACEMENT INDICATOR (ERI) AND WAS EXPLANTED. IT WAS ALLEGED THE DEVICE HAD DEPLETED PREMATURELY. THIS DEVICE IS INCLUDED IN THE (B)(4) 2007, SHORTENED REPLACEMENT WINDOW ADVISORY POPULATION. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VITALITY 2 IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS GUIDANT CRM CLONMEL IRELAND T177

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention