FDA Adverse Event Death Summary report: N

ATTAIN ABILITY PLUS

MDR report key: 2071177 · Received April 27, 2011

Report

Report Number
2649622-2011-07336
Event Type
Death
Date Received
April 27, 2011
Date of Event
March 17, 2011
Report Date
March 14, 2024
Manufacturer
MEDTRONIC PUERTO RICO, INC.
Product Code
OJX
PMA / PMN Number
ASKU
Removal / Correction Number
ASKU
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 1

THIS EVENT OCCURRED OUTSIDE THE U.S. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. PATIENT INFORMATION IS NOT GENERALLY AVAILABLE DUE TO CONFIDENTIALITY CONCERNS. THIS MODEL NUMBER IS NOT APPROVED FOR DISTRIBUTION IN THE UNITED STATES, HOWEVER, IT IS SIMILAR TO A DEVICE MARKETED IN THE U.S. THE EVENT IS BEING REPORTED DUE TO AN ALLEGED OR CONFIRMED MALFUNCTION. ANALYSIS OF THE DEVICE IS IN PROCESS; THE RESULTS WILL BE FORWARDED WHEN AVAILABLE.

Description of Event or Problem · 1

IT WAS REPORTED THE PATIENT DIED APPROXIMATELY SIX WEEKS AFTER DEVICE IMPLANT. THERE WAS A QUESTION REGARDING DEVICE UNDERSENSING. THE CAUSE OF DEATH HAS BEEN REQUESTED AND NOT RECEIVED. THE PATIENT HAD A HISTORY OF CLASS LV HEART FAILURE WITH A NUMBER OF ARRHYTHMIAS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ATTAIN ABILITY PLUS IMPLANTABLE PACING LEAD OJX MEDTRONIC PUERTO RICO, INC. 4296 ASKU

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Death