FDA Adverse Event Injury Summary report: N

ENRHYTHM DR

MDR report key: 2130624 · Received June 16, 2011

Report

Report Number
6000144-2011-03356
Event Type
Injury
Date Received
June 16, 2011
Date of Event
March 20, 2011
Manufacturer
MEDTRONIC MED REL, INC.
Product Code
DXY
PMA / PMN Number
P980035/S38
Removal / Correction Number
Z-1440-2010
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. EVALUATION SUMMARY: (B)(4) THE DEVICE WAS RETURNED AND ANALYZED. CALCULATIONS BASED ON IMPLANT PARAMETERS INDICATE THAT THE DEVICE HAD MET ITS 99.9% EXPECTED LONGEVITY. ANALYSIS OF THE DEVICE MEMORY FOUND THE ERI (ELECTIVE REPLACEMENT INDICATOR) IS THE RESULT OF HIGH INTERNAL BATTERY RESISTANCE. THIS DEVICE IS PART OF THE FIELD ACTION AND HAS TESTED CONSISTENT WITH THE FIELD ACTION.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT CALLED THE CLINIC DUE TO HAVING SYMPTOMS THAT APPEARED TO BE RELATED TO PACING AT VVI 65. IT WAS ALSO REPORTED THAT THE CLINIC HAD THE PATIENT SEND A CARELINK TRANSMISSION TO THE CLINIC WHICH SHOWED THE DEVICE WAS AT ELECTIVE REPLACEMENT INDICATOR STATUS AFTER LESS THAN FIVE YEARS POST IMPLANT. THE DEVICE WAS EXPLANTED AND REPLACED. NO FURTHER PATIENT COMPLICATIONS WERE REPORTED AS A RESULT OF THIS EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT CALLED THE CLINIC DUE TO HAVING SYMPTOMS THAT APPEARED TO BE RELATED TO PACING AT VVI 65. IT WAS ALSO REPORTED THAT THE CLINIC HAD THE PATIENT SEND A CARELINK TRANSMISSION TO THE CLINIC WHICH SHOWED THE DEVICE WAS AT ELECTIVE REPLACEMENT INDICATOR STATUS AFTER LESS THAN FIVE YEARS POST IMPLANT. THE DEVICE WAS EXPLANTED AND REPLACED. NO FURTHER PATIENT COMPLICATIONS WERE REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENRHYTHM DR IMPLANTABLE PULSE GENERATOR DXY MEDTRONIC MED REL, INC. P1501DR ASKU

Patients

Seq Age Sex Outcome Treatment
1 85 YR Hospitalization| L| R 1646T COMPETITOR IMPLANTABLE PACING LEAD| 1646T COMPETITOR IMPLANTABLE PACING LEAD| 1642T COMPETITOR IMPLANTABLE PACING LEAD| 1642T COMPETITOR IMPLANTABLE PACING LEAD