FDA Adverse Event Death Summary report: N

CADENCE V-110 SERIES TIERED THERAPY DEFIBRILLATOR

MDR report key: 206599 · Received January 20, 1999

Report

Report Number
2938836-1999-00027
Event Type
Death
Date Received
January 20, 1999
Date of Event
November 21, 1995
Report Date
November 21, 1995
Manufacturer
*
Product Code
LWS
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

AS A RESULT OF THE PRODUCT NOTIFICATION EFFORT UNDER RECALL Z-232-7, ST JUDE MEDICAL LEARNED THAT THIS PERSON HAD DIED. NO DETAILS REGARDING CAUSE OF DEATH WERE ATTAINABLE FROM THE PHYSICIANS. ST. JUDE SUBSEQUENTLY REQUESTED AND REC'D A DEATH CERTIFICATE. THE CERTIFICATE LISTS VENTRICULAR TACHYCARDIA/FIBRILLATION AS THE IMMEDIATE CAUSE OF DEATH WITH DILATED CARDIOMYOPATHY AND MITRAL VALVE AS CONIDITIONS LEADING TO THE VENTRICULAR TACHYCARDIA. THIS PERSON DIED AS AN INPATIENT, AND THERE HAS BEEN NO REPORT FROM THE USER FACILITY THAT THE DEVICE HAD FAILED TO CONVERT AN ARRHYTHMIA. CO IS, HOWEVER, REPORTING THE DEATH BECAUSE CO HAS NEITHER THE DEVICE NOR ANY ASSOCIATED DATA OR ELECTROGRAMS WHICH WOULD ENABLE CO TO CONCLUDE THAT THE DEVICE DID NOT CONTRIBUTE TO THE DEATH.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CADENCE V-110 SERIES TIERED THERAPY DEFIBRILLATOR Implant IMPLANTABLE CARDIAC DEFIBRILLATOR LWS * V-110C NA

Patients

Seq Age Sex Outcome Treatment
1 52 YR Death CPI 0072, THERAPY DATES: NA.