FDA Adverse Event Injury Summary report: N

VITALITY 2

MDR report key: 2150876 · Received July 6, 2011

Report

Report Number
2124215-2011-06921
Event Type
Injury
Date Received
July 6, 2011
Date of Event
April 1, 2011
Report Date
April 1, 2011
Manufacturer
GUIDANT CRM CLONMEL IRELAND
Product Code
LWS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

UPON RECEIPT AT OUR POST-MARKET QUALITY ASSURANCE LABORATORY, A LONGEVITY CALCULATION CONFIRMED THAT THE DEVICE DID NOT MEET LONGEVITY ESTIMATES PROVIDED IN DEVICE LABELING. PORTIONS OF THE CIRCUITRY, INCLUDING THE BATTERY, WERE ISOLATED AND TESTED. FINAL ANALYSIS CONCLUDED THAT THE PREMATURE BATTERY DEPLETION WAS DUE TO LOW-VOLTAGE CAPACITOR DEGRADATION, WHICH RESULTED IN A HIGH CURRENT CONDITION.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (ICD) WAS IN STORAGE MODE. A BOSTON SCIENTIFIC TECHNICAL SERVICES CONSULTANT STATED THAT IS DUE TO A LOW BATTERY. THE DEVICE WAS EXPLANTED WITHOUT FURTHER INCIDENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VITALITY 2 IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS GUIDANT CRM CLONMEL IRELAND T175

Patients

Seq Age Sex Outcome Treatment
1 66 YR 0174| T175