SELECTSECURE MRI SURESCAN
Report
- Report Number
- 2649622-2026-11856
- Event Type
- Injury
- Date Received
- April 27, 2026
- Date of Event
- April 8, 2026
- Report Date
- April 27, 2026
- Manufacturer
- MEDTRONIC PUERTO RICO VILLALBA
- Product Code
- NVN
- UDI-DI
- 00763000740269
- PMA / PMN Number
- P030036
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- VA, US
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
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.
IT WAS REPORTED THAT ON THE SAME DAY AS IMPLANT THE RIGHT VENTRICULAR (RV) LEFT BUNDLE BRANCH LEAD EXHIBITED HIGH THRESHOLD POST ATR IOVENTRICULAR JUNCTION (AVJ) ABLATION. THE PATIENT EXPERIENCED SYMPTOMS AND THE SURGEON SUSPECTS LOCAL BURNED TISSUE CAUSE HIGH THRESHOLD OBSERVED POST ABLATION. THE LEAD WAS EXPLANTED 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 |
|---|---|---|---|---|---|---|---|
| 26176 | SELECTSECURE MRI SURESCAN | DRUG ELUTING PERMANENT RIGHT VENTRICULAR (RV) | NVN | MEDTRONIC PUERTO RICO VILLALBA | 383069 | 00763000740269 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 85 YR | Female | Hospitalization| R | W1DR01 IPG, 383059 LEAD. |