FDA Adverse Event Injury Summary report: N

CURRENT RF DR

MDR report key: 2242455 · Received September 10, 2011

Report

Report Number
2017865-2011-06194
Event Type
Injury
Date Received
September 10, 2011
Date of Event
June 27, 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

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

Additional Manufacturer Narrative · 1

THE REPORTED EVENT OF SUSPECTED PREMATURE BATTERY DEPLETION WAS NOT CONFIRMED. A LONGEVITY CALCULATION WAS PERFORMED AND BASED ON THE DEVICE'S PROGRAMMED PARAMETERS AND DIAGNOSTICS, THE BATTERY WAS FOUND TO BE WITHIN EXPECTED LONGEVITY PERFORMANCE. THE DEVICE'S FUNCTIONALITY WAS TESTED; NO ANOMALY WAS DETECTED. THE DEVICE IS NORMAL.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE WAS EXPLANTED DUE TO SUSPECTED PREMATURE BATTERY DEPLETION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CURRENT RF DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 2207-36 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention