FDA Adverse Event Malfunction Summary report: N

VITALITY 2

MDR report key: 2172890 · Received July 22, 2011

Report

Report Number
2124215-2011-10085
Event Type
Malfunction
Date Received
July 22, 2011
Date of Event
June 9, 2011
Report Date
June 9, 2011
Manufacturer
GUIDANT CRM CLONMEL IRELAND
Product Code
LWS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

A REVIEW OF DEVICE MEMORY REVEALED THAT THE DEVICE DECLARED ELECTIVE REPLACEMENT INDICATOR (ERI) AFTER EXPERIENCING TWO CONSECUTIVE CHARGE TIMES GREATER THAN THE EXTENDED MID-LIFE ERI CHARGE TIME LIMIT. THE OBSERVED RATE OF BATTERY USAGE WAS COMPARED TO THE EXPECTED RATE OF BATTERY USAGE; THE RESULTS INDICATED THAT THE MONITORING VOLTAGE WAS NORMAL. ALTHOUGH THE BATTERY ITSELF HAD NOT DEPLETED PREMATURELY, ERI WAS TRIGGERED EARLIER THAN EXPECTED BY EXTENDED CHARGE TIMES DUE TO A HIGHER-THAN-TYPICAL BUILD-UP OF INTERNAL BATTERY IMPEDANCE.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS DEVICE WAS EXPLANTED DUE TO AN UNSPECIFIED REASON. TO DATE, NO ADVERSE PATIENT EFFECTS WERE REPORTED WITH THIS CLINICAL OBSERVATION. THE DEVICE WAS RETURNED TO ALLOW FOR RELIABILITY ANALYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VITALITY 2 IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS GUIDANT CRM CLONMEL IRELAND T177

Patients

Seq Age Sex Outcome Treatment
1 55 YR 0185| T177