FDA Adverse Event Injury Summary report: N

MICRA¿ AV2

MDR report key: 23035413 · Received September 12, 2025

Report

Report Number
9612164-2025-04523
Event Type
Injury
Date Received
September 12, 2025
Date of Event
August 18, 2025
Report Date
September 15, 2025
Manufacturer
MEDTRONIC IRELAND
Product Code
PNJ
UDI-DI
00763000916428
PMA / PMN Number
P150033
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

CORRECTED: B5, H2, ADDITIONAL CODES. MEDTRONIC SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.

Additional Manufacturer Narrative · 0

THIS IS A SYSTEM REPORT. THE SECTION D INFORMATION IS FOR THE PRIMARY DEVICE, WHICH WAS IN USE WITH THE FOLLOWING: BRAND NAME [MICRA] PRODUCT ID [MC2AVR1-DELSYS] (SERIAL: (B)(6). D9: NO MEDTRONIC SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.

Description of Event or Problem · 0

IT WAS FURTHER REPORTED THAT THE PATIENT EXPERIENCED INTERMITTENT CARDIAC ARREST DURING THE IMPLANT PROCEDURE.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING THE IMPLANT PROCEDURE OF THE LEADLESS IMPLANTABLE PULSE GENERATOR (IPG) DELIVERY SYSTEM (DS) BEFORE PLACEMENT NEGATIVE PRESSURE WAS APPLIED VIA A SYRINGE THROUGH THE FLUSH PORT OF THE INTRODUCER HOWEVER THE SYRINGE COULD NOT BE PULLED BACK, PREVENTING AIR REMOVAL. WHEN THE DEFLECTION BUTTON WAS PRESSED ON THE LEADLESS IMPLANTABLE PULSE GENERATOR (IPG) (DS) NO RESPONSE WAS OBSERVED AND THE LEADLESS IPG WAS PROTRUDING. THE LEADLESS IPG DS AND INTRODUCER WERE ATTEMPTED NOT USED AND REPLACED. NO FURTHER PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2192245 MICRA¿ AV2 LEADLESS PACEMAKER PNJ MEDTRONIC IRELAND MC2AVR1 00763000916428

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Life Threatening