FDA Adverse Event Injury Summary report: N

ATLAS PLUS DR

MDR report key: 2243107 · Received September 11, 2011

Report

Report Number
2017865-2011-06640
Event Type
Injury
Date Received
September 11, 2011
Date of Event
July 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

BASED ON DEVICE SETTINGS, THE DEVICE MET THE EXPECTED LONGEVITY. THE BATTERY WAS SENT TO THE VENDOR. NO ANOMALIES WERE FOUND. THE CAUSE OF DROP IN BATTERY VOLTAGE AND THE PREMATURE BATTERY DEPLETION COULD NOT BE DETERMINED.

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 THE DEVICE COULD NOT BE INTERROGATED. PREMATURE BATTERY DEPLETION SUSPECTED. THE DEVICE WAS EXPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ATLAS PLUS DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION V-243 NA

Patients

Seq Age Sex Outcome Treatment
1 76 YR Required Intervention