FDA Adverse Event Injury Summary report: N

ALTRUA

MDR report key: 2151426 · Received July 6, 2011

Report

Report Number
2124215-2011-06358
Event Type
Injury
Date Received
July 6, 2011
Date of Event
February 18, 2011
Report Date
April 5, 2011
Manufacturer
GUIDANT CRM CLONMEL IRELAND
Product Code
NVZ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS INVESTIGATION WILL BE UPDATED SHOULD FURTHER INFORMATION BE PROVIDED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THE PATIENT WITH THIS DEVICE HAS BEEN HOSPITALIZED SINCE (B)(6) POST IMPLANT, DUE TO A MASSIVE RIGHT ISCHEMIC STROKE, DIAGNOSED VIA A BRAIN COMPUTED TOMOGRAPHY (CT) SCAN. THE TRANSESOPHAGEAL ECHOCARDIOGRAM (TEE) EXHIBITED A LEFT ATRIAL THROMBUS AND THE POSSIBILITY OF A RIGHT ATRIAL THROMBUS. NO FURTHER INFORMATION HAS BEEN COMMUNICATED; PATIENT REMAINS HOSPITALIZED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ALTRUA IMPLANTABLE PULSE GENERATOR NVZ GUIDANT CRM CLONMEL IRELAND S601

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| L