FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 2161265 · Received July 13, 2011

Report

Report Number
2124215-2011-06860
Event Type
Injury
Date Received
July 13, 2011
Date of Event
April 14, 2011
Report Date
April 14, 2011
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

ALL AVAILABLE INFORMATION INDICATES THAT THE LEAD REMAINS INACTIVELY IMPLANTED. AS NO FURTHER INFORMATION CONCERNING THIS REPORT IS EXPECTED, OUR INVESTIGATION IS COMPLETE. THIS INVESTIGATION WILL BE UPDATED SHOULD FURTHER INFORMATION BE PROVIDED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT RIGHT ATRIAL (RA) IMPEDANCE MEASUREMENTS WERE REPORTED TO BE UNUSUALLY HIGH. AN INVASIVE REVISION PROCEDURE WAS PERFORMED AND THE RA LEAD WAS SURGICALLY ABANDONED AND REPLACED WITHOUT COMPLICATION. THE DEVICE WAS ELECTIVELY EXPLANTED AND REPLACED. NO OTHER ADVERSE PATIENT EFFECTS WERE REPORTED WITH THIS CLINICAL OBSERVATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4473

Patients

Seq Age Sex Outcome Treatment
1 68 YR H210| 4473| 0180| 4543| 4549