FDA Adverse Event Injury Summary report: N

ATLAS II VR

MDR report key: 2242401 · Received September 10, 2011

Report

Report Number
2017865-2011-06615
Event Type
Injury
Date Received
September 10, 2011
Date of Event
June 20, 2011
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
LWS
PMA / PMN Number
P910023
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE REPORTED PREMATURE BATTERY DEPLETION WAS NOT CONFIRMED IN THE LABORATORY. BASED ON THE DEVICE'S PARAMETERS, IT IS WITHIN EXPECTED LONGEVITY PERFORMANCE. THE DEVICE WAS TESTED ON THE BENCH AND ON OUR AUTOMATED TESTING EQUIPMENT AND WAS FOUND TO BE NORMAL. THE DEVICE MET ALL SPECIFICATIONS.

Additional Manufacturer Narrative · 1

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED. OTHER TEXT: DEVICE EVALUATION ANTICIPATED, BUT NOT YET BEGUN.

Description of Event or Problem · 1

IT WAS REPORTED THAT PREMATURE ERI WAS SUSPECTED. DEVICE WAS EXPLANTED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ATLAS II VR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION V-168 NA

Patients

Seq Age Sex Outcome Treatment
1 49 YR Required Intervention