FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 2041201 · Received April 6, 2011

Report

Report Number
2124215-2011-00926
Event Type
Injury
Date Received
April 6, 2011
Date of Event
January 10, 2011
Report Date
January 28, 2011
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

THIS PRODUCT IS CURRENTLY UNDERGOING DETAILED ANALYSIS. THIS EVENT WILL BE UPDATED UPON COMPLETION OF ANALYSIS.

Additional Manufacturer Narrative · 1

AS NO FURTHER INFORMATION CONCERNING THIS REPORT IS EXPECTED, OUR INVESTIGATION IS COMPLETE. THIS INVESTIGATION WILL BE UPDATED SHOULD FURTHER INFORMATION BE PROVIDED.

Additional Manufacturer Narrative · 1

UPON RECEIPT IN OUR POST MARKET QUALITY ASSURANCE LABORATORY, THE LEAD WAS RETURNED SEVERED 26.5 CENTIMETERS (CM) FROM THE TERMINAL PIN; THE PROXIMAL SEGMENT ONLY WAS RETURNED. A SETSCREW MARK WAS NOTED ON THE TERMINAL PIN AND RING. RESISTANCE AND PRESSURE TESTS WERE COMPLETED TO ASSESS THE ELECTRICAL PERFORMANCE AND INSULATION INTEGRITY OF THE RETURNED LEAD SEGMENT. MEASUREMENTS THROUGHOUT THESE TESTS WERE WITHIN NORMAL LIMITS. LABORATORY TESTING WAS UNABLE TO REPRODUCE THE REPORTED CLINICAL OBSERVATIONS AND DETAILED ANALYSIS DID NOT REVEAL ANY ABNORMALITIES.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS RIGHT VENTRICULAR (RV) LEAD EXHIBITED DECREASED SENSING AND LOSS OF CAPTURE. A REVISION PROCEDURE WAS THEREFORE PERFORMED. AN ATTEMPT WAS MADE TO EXTRACT THE LEAD; HOWEVER, WAS UNSUCCESSFUL AND THE TIP OF THE LEAD REMAINS IN THE PATIENT. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 1

THE LEAD WAS LATER RETURNED FOR ANALYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4471

Patients

Seq Age Sex Outcome Treatment
1 81 YR Required Intervention T167| 4471| 0184| E110| 0157| 4469| A155