FDA Adverse Event Injury Summary report: N

CURRENT RF DR

MDR report key: 2242830 · Received September 11, 2011

Report

Report Number
2017865-2011-06192
Event Type
Injury
Date Received
September 11, 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
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

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

Additional Manufacturer Narrative · 1

THE DEVICE WAS FOUND TO BE BELOW THE EXPECTED LONGEVITY LIMITS BASED ON ALL AVAILABLE PARAMETER AND USAGE INFORMATION. HIGH CURRENT WAS OBSERVED IN THE RF MODULE CIRCUITRY; THIS ANOMALY CAUSED THE PREMATURE BATTERY DEPLETION. THE BATTERY WAS SENT TO THE VENDOR FOR FURTHER ANALYSIS. AN INTERNAL BATTERY ANOMALY WAS FOUND.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE BATTERY VOLTAGE WAS EXCESSIVELY DISCHARGING FASTER THAN EXPECTED. THE DEVICE WILL BE EXPLANTED.

Description of Event or Problem · 1

THE DEVICE WAS EXPLANTED.

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 58 YR Required Intervention