FDA Adverse Event Malfunction Summary report: N

FINELINE II

MDR report key: 2042282 · Received April 6, 2011

Report

Report Number
2124215-2011-02323
Event Type
Malfunction
Date Received
April 6, 2011
Date of Event
January 17, 2011
Report Date
January 17, 2011
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
PMA / PMN Number
P960004
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

A BOSTON SCIENTIFIC TECHNICAL SERVICES CONSULTANT DISCUSSED THE CLINICAL OBSERVATIONS WITH THE CALLER. THE CONSULTANT EXPRESSED CONCERN REGARDING THE PERFORMANCE OF THIS LEAD. ACCORDING TO OUR RECORDS, THE LEAD REMAINS ACTIVELY IMPLANTED AND NO OTHER ADVERSE EVENTS HAVE BEEN REPORTED. THIS ISSUE WILL BE RE-EVALUATED IF ADDITIONAL INFORMATION IS RECEIVED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS ATRIAL LEAD WAS EXHIBITING IMPEDANCE MEASUREMENTS GREATER THAN 2500 OHMS, NOISE, SMALL P-WAVES AND SOME UNDERSENSING. THE CALLER ALSO REPORTED THAT LOSS OF CAPTURE WAS OBSERVED WITH THE ASSOCIATED RIGHT VENTRICULAR LEAD DURING ATRIAL SENSING TESTS IN DDD CONFIGURATION. A REVIEW OF THE ASSOCIATED STRIPS SHOW POTENTIAL OVERSENSING WITH SOME PACING INHIBITION. THE PATIENT WAS ASYMPTOMATIC.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4472

Patients

Seq Age Sex Outcome Treatment
1 79 YR S208| 1284| 4472| 4458