FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 2173171 · Received July 23, 2011

Report

Report Number
2124215-2011-10830
Event Type
Injury
Date Received
July 23, 2011
Date of Event
April 16, 2011
Report Date
June 5, 2012
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

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 THIS PRODUCT WAS PART OF A SYSTEM EXPLANT DUE TO INFECTION. THERE WERE NO ADDITIONAL ADVERSE EFFECTS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4471

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| L| R