FDA Adverse Event Injury Summary report: N

ENRHYTHM DR

MDR report key: 2790274 · Received October 15, 2012

Report

Report Number
6000144-2012-05701
Event Type
Injury
Date Received
October 15, 2012
Date of Event
June 28, 2012
Manufacturer
MEDTRONIC MED REL, INC.
Product Code
DXY
PMA / PMN Number
P980035/S38
Removal / Correction Number
Z-1440-2010
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IA, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. EVALUATION SUMMARY: (B)(4) THE ACTUAL DEVICE WAS NOT RECEIVED FOR EVALUATION. WE DID RECEIVE PERFORMANCE DATA COLLECTED FROM THE DEVICE AND HAVE ANALYZED THE DATA. DEVICE EXPERIENCED A CRITICAL RAM PARITY ERROR POWER ON RESET (POR) ON (B)(6) 2012 IN LOCATION "10 EF". DEVICE SHOULD BE ABLE TO RECOVER FROM THE EVENT AND CONTINUE NORMAL FUNCTION.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A ROUTINE DEVICE CHECK THE DEVICE WAS AT VVI65 AND IT WAS NOTED THAT THE DEVICE HAD A CRITICAL RAM PARITY ERROR AND POWER ON RESET. IT WAS ALSO NOTED THAT A SOFTWARE UPDATE WAS INSTALLED THAT DAY AND THE BATTERY VOLTAGE MEASUREMENT WAS BELOW THE ELECTIVE REPLACEMENT INDICATOR (ERI) VOLTAGE. A REMOTE TRANSMISSION REPORT WILL BE DONE IN FIVE DAYS TO SEE IF ERI IS REACHED. THE DEVICE WAS REPROGRAMMED AND REMAINS IN USE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENRHYTHM DR IMPLANTABLE PULSE GENERATOR DXY MEDTRONIC MED REL, INC. P1501DR

Patients

Seq Age Sex Outcome Treatment
1 97 YR Required Intervention 5076 X2 IMPLANTABLE PACING LEADS