FDA Adverse Event Malfunction Summary report: N

MICRA

MDR report key: 20674358 · Received November 13, 2024

Report

Report Number
9612164-2024-05258
Event Type
Malfunction
Date Received
November 13, 2024
Date of Event
November 5, 2024
Report Date
November 26, 2024
Manufacturer
MEDTRONIC IRELAND
Product Code
PNJ
PMA / PMN Number
P150033
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

PRODUCT EVENT SUMMARY: A PARTIAL DELIVERY SYSTEM WAS RETURNED AND ANALYZED. THE DELIVERY SYSTEM OUTER SHAFT WAS KINKED/BUCKLED. THE DELIVERY SYSTEM INNER SHAFT WAS MECHANICALLY KINKED/BENT. VISUAL ANALYSIS OF THE DELIVERY SYSTEM INDICATED DAMAGE DURING USE. THE ANALYST NOTED A PARTIAL DELIVERY SYSTEM WAS RETURNED WITHOUT THE DEVICE, TETHER, AND TETHER PIN. THE OUTER SHAFT WAS KINK/BUCKLED AT 6 CM FROM THE DISTAL END OF THE DELIVERY SYSTEM. THE INNER SHAFT IS KINKED AT 3.5 CM FROM THE DISTAL END OF THE RECAPTURE CONE. THERE WERE NO ANOMALIES FOUND DURING ARTICULATION. MEDTRONIC SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.

Additional Manufacturer Narrative · 0

MEDTRONIC SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.

Additional Manufacturer Narrative · 0

MEDTRONIC SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.

Additional Manufacturer Narrative · 0

MEDTRONIC SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.

Description of Event or Problem · 0

IT WAS REPORTED DURING IMPLANT OF A LEADLESS IMPLANTABLE PULSE GENERATOR (IPG) THAT THE DELIVERY FORCE WAS NOT TRANSMITTED TO THE TIP OF THE DELIVERY SYSTEM (DS). IT WAS ALSO REPORTED THAT THE STRENGTH OF THE DS WAS LESS THAN OTHER IMPLANTS. IT WAS FURTHER REPORTED THAT THE PHYSICIAN FELT THAT THE DS HAD LESS RESISTANCE THAN OTHER IMPLANTS. THE LEADLESS IPG WAS SUCCESSFULLY IMPLANTED AND REMAINS IN USE AND THE DS WAS REMOVED. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Description of Event or Problem · 0

IT WAS REPORTED DURING IMPLANT OF A LEADLESS IMPLANTABLE PULSE GENERATOR (IPG) THAT THE DELIVERY FORCE WAS NOT TRANSMITTED TO THE TIP OF THE DELIVERY SYSTEM (DS). IT WAS ALSO REPORTED THAT THE STRENGTH OF THE DS WAS LESS THAN OTHER IMPLANTS. IT WAS FURTHER REPORTED THAT THE PHYSICIAN FELT THAT THE DS HAD LESS RESISTANCE THAN OTHER IMPLANTS THE LEADLESS IPG WAS SUCCESSFULLY IMPLANTED AND WAS LATER REMOVED. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Description of Event or Problem · 0

IT WAS REPORTED DURING IMPLANT OF A LEADLESS IMPLANTABLE PULSE GENERATOR (IPG) THAT THE DELIVERY FORCE WAS NOT TRANSMITTED TO THE TIP OF THE DELIVERY SYSTEM (DS). IT WAS ALSO REPORTED THAT THE STRENGTH OF THE DS WAS LESS THAN OTHER IMPLANTS. IT WAS FURTHER REPORTED THAT THE PHYSICIAN FELT THAT THE DS HAD LESS RESISTANCE THAN OTHER IMPLANTS THE LEADLESS IPG WAS SUCCESSFULLY IMPLANTED AND REMAINS IN USE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2069293 MICRA LEADLESS PACEMAKER PNJ MEDTRONIC IRELAND MC1VR01-DELSYS

Patients

Seq Age Sex Outcome Treatment
1 NA Male