FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 2153539 · Received July 7, 2011

Report

Report Number
2124215-2011-06262
Event Type
Injury
Date Received
July 7, 2011
Date of Event
April 5, 2011
Report Date
April 6, 2011
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
PMA / PMN Number
P960004
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

AT THIS TIME, THIS LEAD HAS NOT BEEN RETURNED. IF ADDITIONAL INFORMATION IS RECEIVED, THIS REPORT WILL BE UPDATED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS RIGHT ATRIAL (RA) LEAD WAS EXPLANTED DUE TO AN INFECTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4472

Patients

Seq Age Sex Outcome Treatment
1 70 YR Required Intervention 4456| 4473| 4457| 1298| 4472