FDA Adverse Event Injury Summary report: N

VIRTUOSO VR

MDR report key: 2791703 · Received October 15, 2012

Report

Report Number
6000144-2012-05534
Event Type
Injury
Date Received
October 15, 2012
Manufacturer
MEDTRONIC MED REL, INC.
Product Code
LWS
PMA / PMN Number
P980016/S062
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
PHYSICIAN

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 FOR: (B)(4) NORMAL DEPLETION - THE DEVICE WAS RETURNED, ANALYZED AND ANALYSIS OF THE DEVICE REVEALED NORMAL BATTERY DEPLETION.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE BATTERY WAS AT ELECTIVE REPLACEMENT INDICATOR. IT WAS ALSO REPORTED THAT THERE MAY BE EARLY BATTERY DEPLETION. THE DEVICE WAS REMOVED AND REPLACED. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VIRTUOSO VR IMPLANTABLE PACEMAKER/CARDIO/DEFIB LWS MEDTRONIC MED REL, INC. D154VWC

Patients

Seq Age Sex Outcome Treatment
1 52 YR Hospitalization| R 6947 IMPLANTABLE TACHY LEAD