FDA Adverse Event Malfunction Summary report: N

TELIGEN

MDR report key: 2053032 · Received April 13, 2011

Report

Report Number
2124215-2011-04253
Event Type
Malfunction
Date Received
April 13, 2011
Date of Event
March 2, 2011
Report Date
March 15, 2011
Manufacturer
GUIDANT CRM CLONMEL IRELAND
Product Code
LWS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

A REVIEW OF THE LATITUDE WEBSITE CONFIRMED THAT THE SHOCK IMPEDANCE MEASUREMENTS HAVE RANGED FROM 80 TO ABOVE 125 OHMS. IT WAS ALSO CONFIRMED THAT THE MEASUREMENTS DID GO ABOVE 125 OHMS ON TWO OCCASIONS WHICH BOTH TRIGGERED RED ALERTS. THE TS REPRESENTATIVE DISCUSSED THAT A REVIEW OF THE MEASUREMENTS SHOW THAT THE SHOCK IMPEDANCES HAVE ARE WITHIN THE UPPER RANGE, MOST LIKELY DUE THE DEFIBRILLATION LEAD BEING A SINGLE COIL LEAD. THE MEASURED IMPEDANCES CAN CHANGE MORE THAN 20 OHMS ON A DAY TO DAY BASIS, MAKING IT POSSIBLE TO HAVE THE MEASURED VALUES CROSS THE 125 OHMS MEASUREMENT AND TRIGGER A RED ALERT. AT THIS TIME, THE DEVICE AND LEAD REMAIN IMPLANTED AND IN SERVICE. NO ADDITIONAL INFORMATION IS AVAILABLE. 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

THE PHYSICIAN WAS NOTIFIED OF THE RED ALERT AND A CONSULTATION HAS BEEN PERFORMED. AT THIS TIME, THIS LEAD AND DEVICE REMAIN IMPLANTED AND IN SERVICE. NO ADDITIONAL INFORMATION IS AVAILABLE. IF ANY ADDITIONAL INFORMATION DOES BECOME AVAILABLE, THIS REPORT WILL BE UPDATED.

Description of Event or Problem · 1

THE INFORMATION WAS SENT TO BOSTON SCIENTIFIC TECHNICAL SERVICES (TS) FOR FURTHER EVALUATION.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT A RED ALERT WAS ISSUED THROUGH THE LATITUDE SYSTEM AFTER THIS IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (ICD) DETECTED A HIGH SHOCK IMPEDANCE MEASUREMENT ON THE RIGHT VENTRICULAR (RV) LEAD. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TELIGEN IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS GUIDANT CRM CLONMEL IRELAND F110

Patients

Seq Age Sex Outcome Treatment
1 Other