FDA Adverse Event Injury Summary report: N

VITALITY 2

MDR report key: 2053637 · Received April 13, 2011

Report

Report Number
2124215-2011-05964
Event Type
Injury
Date Received
April 13, 2011
Date of Event
March 4, 2011
Report Date
March 4, 2011
Manufacturer
GUIDANT CRM CLONMEL IRELAND
Product Code
LWS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

A REVIEW OF DEVICE MEMORY REVEALED THAT THE DEVICE DECLARED ELECTIVE REPLACEMENT INDICATOR (ERI) AFTER EXPERIENCING TWO CONSECUTIVE CHARGE TIMES GREATER THAN THE EXTENDED MID-LIFE ERI CHARGE TIME LIMIT. THE OBSERVED RATE OF BATTERY USAGE WAS COMPARED TO THE EXPECTED RATE OF BATTERY USAGE; THE RESULTS INDICATED THAT THE MONITORING VOLTAGE WAS NORMAL. ALTHOUGH THE BATTERY ITSELF HAD NOT DEPLETED PREMATURELY, ERI WAS TRIGGERED EARLIER THAN EXPECTED BY EXTENDED CHARGE TIMES DUE TO A HIGHER-THAN-TYPICAL BUILD-UP OF INTERNAL BATTERY IMPEDANCE.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS DEVICE DECLARED ELECTIVE REPLACEMENT INDICATOR (ERI) AND A CHANGEOUT PROCEDURE WAS PERFORMED. IT WAS REPORTED THAT THE PATIENT IMPLANTED WITH THIS DEVICE ENTERED VENTRICULAR TACHYCARDIA (VT) ARRHYTHMIAS FREQUENTLY AND REQUIRED ANTI-TACHYCARDIA PACING (ATP). AN ALLEGATION REGARDING THE UNEXPECTED BATTERY DEPLETION WAS MADE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VITALITY 2 IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS GUIDANT CRM CLONMEL IRELAND T175

Patients

Seq Age Sex Outcome Treatment
1 44 YR T175| T135| 1793| 0144