FDA Adverse Event
Injury
Summary report: N
LUX-DX INSERTABLE CARDIAC MONITOR
MDR report key: 21324139
·
Received February 6, 2025
Report
- Report Number
- 2124215-2025-06514
- Event Type
- Injury
- Date Received
- February 6, 2025
- Date of Event
- January 1, 2024
- Report Date
- February 6, 2025
- Manufacturer
- BOSTON SCIENTIFIC CORPORATION
- Product Code
- MXD
- UDI-DI
- 00802526607103
- PMA / PMN Number
- K193473
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MS, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 0
FIELD G4 PREMARKET/510K IN SECTION G, ALL MANUFACTURERS, CONTAINS BOTH DOCUMENTS K193473 AND K210608 WHOSE CHARACTER LIMIT PREVENTED BOTH ENTRIES FROM THE FIELD. GOOD FAITH EFFORT ATTEMPTS WERE MADE TO TRY AND RETRIEVE ADDITIONAL DETAILS REGARDING THE REPORTED EVENT AND PRODUCT RETURN STATUS. AT THIS TIME, NO INFORMATION HAS BEEN RECEIVED. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.
Description of Event or Problem · 0
IT WAS REPORTED BY THE PATIENT THAT THEIR INSERTABLE CARDIAC MONITOR (ICM) DEVICE HAD BEEN EXPLANTED AND THAT THEY WERE DISSATISFIED. NO ADVERSE PATIENT EFFECTS WERE REPORTED. THIS ICM DEVICE HAS NOT BEEN RETURNED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 909881 | LUX-DX INSERTABLE CARDIAC MONITOR | INSERTABLE CARDIAC MONITOR | MXD | BOSTON SCIENTIFIC CORPORATION | M301 | 169280 | 00802526607103 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 73 YR | Male | Required Intervention| H |