FDA Adverse Event Malfunction Summary report: N

OVATIO

MDR report key: 2782096 · Received October 5, 2012

Report

Report Number
9610579-2012-00096
Event Type
Malfunction
Date Received
October 5, 2012
Date of Event
September 12, 2012
Report Date
September 14, 2012
Manufacturer
SORIN CRM
Product Code
MRM
PMA / PMN Number
P980049
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS EVENT CONCERNS A DEVICE THAT WAS MANUFACTURED AND USED OUTSIDE THE UNITED STATES. ANALYSIS IS PENDING.

Description of Event or Problem · 1

REPORTEDLY, DURING A VALVE REPLACEMENT PROCEDURE PERFORMED ON (B)(6) 2012, VT INDUCTION AND ATP DELIVERY FEATURES IN EPS SCREEN WERE USED TO TRY TO PACE THE HEART AT 200 MIN-1 DURING 8 SECONDS. HOWEVER, THE MARKER CHANNEL WAS DISPLAYED WITHOUT ANY MARKERS VISUALIZED. AN EXPLANATION IS REQUIRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 OVATIO MRM SORIN CRM OVATIO DR 6550 M090206

Patients

Seq Age Sex Outcome Treatment
1