FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 2162571 · Received July 14, 2011

Report

Report Number
2124215-2011-07194
Event Type
Injury
Date Received
July 14, 2011
Date of Event
April 20, 2011
Report Date
April 20, 2011
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

THIS LEAD WAS ABANDONED, THEREFORE, BOSTON SCIENTIFIC CRM WILL BE UNABLE TO PERFORM ANALYSIS ON THIS LEAD. SHOULD IT BE RETURNED, OR IF ADDITIONAL INFORMATION BECOMES AVAILABLE, THIS EVENT WILL BE UPDATED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS RIGHT VENTRICULAR LEAD EXHIBITED IMPEDANCE MEASUREMENTS GREATER THAN 2500 OHMS. AS A FRACTURE WAS SUSPECTED, THE LEAD WAS SURGICALLY ABANDONED. NO ADVERSE PATIENT EFFECTS WERE NOTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4458

Patients

Seq Age Sex Outcome Treatment
1 73 YR Required Intervention 4458| S603| 1284| 4479