FDA Adverse Event Injury Summary report: N

RIATA ACTIVE FIXATION

MDR report key: 2242635 · Received September 10, 2011

Report

Report Number
2017865-2011-06124
Event Type
Injury
Date Received
September 10, 2011
Date of Event
June 1, 2011
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
NVY
PMA / PMN Number
P950022
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 ELECTRICAL TESTING OF THE LEAD REVEALED A SHORT CIRCUIT BETWEEN THE PACING AND SENSING COIL. EXTERNAL INSULATION ABRASION WAS FOUND, EXPOSING THE PACING AND SENSING CABLES. THE ABRASION FOUND WAS CONSISTENT WITH FRICTION TO THE ICD CAN. THIS COULD ACCOUNT FOR DECREASED SENSING AND LOW HV IMPEDANCE MEASUREMENTS.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING MANUAL TESTING SOME SIGNALS WERE NOTED ON THE STORED ELECTROGRAMS. BOTH LEADS SHOWED A DECREASE IN IMPEDANCE. SENSING HAD DECREASED IN THE VENTRICLE. LEAD DAMAGE SUSPECTED. LEAD WAS EXPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 RIATA ACTIVE FIXATION DEFIBRILLATION LEAD NVY ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 1581/65 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention 1999/52 (B)(4)