FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 2163303 · Received July 15, 2011

Report

Report Number
2124215-2011-07196
Event Type
Injury
Date Received
July 15, 2011
Date of Event
April 22, 2011
Report Date
April 22, 2011
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
PMA / PMN Number
P960004
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS RA LEAD WAS DISCARDED AT THE HOSPITAL, SO THEREFORE WILL NOT BE RETURNED TO BOSTON SCIENTIFIC FOR LABORATORY ANALYSIS. AT THIS TIME THERE IS NO ADDITIONAL INFORMATION. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE 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 INFECTION. A NEW SYSTEM WAS IMPLANTED SUCCESSFULLY. THERE WERE NO ADDITIONAL ADVERSE PATIENT EFFECTS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4480

Patients

Seq Age Sex Outcome Treatment
1