FDA Adverse Event Injury Summary report: N

ATLAS PLUS VR

MDR report key: 2242446 · Received September 10, 2011

Report

Report Number
2017865-2011-06626
Event Type
Injury
Date Received
September 10, 2011
Date of Event
July 6, 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

BASED ON DEVICE SETTINGS, THE DEVICE WAS BELOW THE OVERALL EXPECTED LONGEVITY. NO HIGH CURRENT DRAIN SOURCES WERE FOUND THROUGHOUT BENCH AND AUTOMATED TESTING. THE BATTERY WAS SENT TO THE VENDOR. NO ANOMALIES WERE FOUND THAT WOULD CAUSE PREMATURE DEPLETION. THE CAUSE OF THE PREMATURE BATTERY DEPLETION COULD NOT BE DETERMINED.

Additional Manufacturer Narrative · 1

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED.

Description of Event or Problem · 1

IT WAS REPORTED THAT NO COMMUNICATION COULD BE ESTABLISHED. DEVICE WAS EXPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ATLAS PLUS VR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION V-193 NA

Patients

Seq Age Sex Outcome Treatment
1 55 YR Required Intervention