FDA Adverse Event Injury Summary report: N

REPLY DR

MDR report key: 2061581 · Received April 18, 2011

Report

Report Number
2182863-2011-00030
Event Type
Injury
Date Received
April 18, 2011
Date of Event
March 11, 2011
Report Date
March 21, 2011
Manufacturer
SORIN BIOMEDICA CRM S.R.L.
Product Code
DXY
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

APRIL 18, 2011. THE ANALYSIS ON THIS DEVICE IS PENDING.

Additional Manufacturer Narrative · 1

(B)(4), 2011. THE ANALYSIS ON THIS DEVICE IS PENDING. (B)(4), 2011.

Description of Event or Problem · 1

ONE DAY POST IMPLANT, THE IMPEDANCE WAS AROUND 210 OHMS IN BIPOLAR WITH FAILURE TO SENSE OR CAPTURE. AN INTERVENTION WAS PERFORMED AND THE VENTRICULAR OSCOR LEAD WAS FOUND TO HAVE AN INSULATION BREAK. THE LEAD WAS REPLACED ALONG WITH THIS PACEMAKER SINCE A NEW PACEMAKER BOX HAD BEEN OPENED.

Description of Event or Problem · 1

ONE DAY POST IMPLANT, THE IMPEDANCE WAS AROUND 210 OHMS IN BIPOLAR WITH FAILURE TO SENSE OR CAPTURE. AN INTERVENTION WAS PERFORMED AND THE VENTRICULAR OSCOR LEAD WAS FOUND TO HAVE AN INSULATION BREAK. THE LEAD WAS REPLACED ALONG WITH THIS PACEMAKER SINCE A NEW PACEMAKER BOX HAD BEEN OPENED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 REPLY DR CARDIAC PACEMAKER DXY SORIN BIOMEDICA CRM S.R.L. REPLY DR

Patients

Seq Age Sex Outcome Treatment
1 86 YR