FDA Adverse Event Malfunction Summary report: N

TRANSVENE SVC/CS

MDR report key: 2810162 · Received October 31, 2012

Report

Report Number
2182208-2012-03669
Event Type
Malfunction
Date Received
October 31, 2012
Manufacturer
MEDTRONIC, INC.
Product Code
LWS
PMA / PMN Number
P980050/S1
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UT, 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.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE LEADS WERE MEASURING HIGH IMPEDANCES. THE LEADS REMAIN IN USE AND WILL BE MONITORED. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TRANSVENE SVC/CS IMPLANTABLE TACHY LEAD LWS MEDTRONIC, INC. 6937A

Patients

Seq Age Sex Outcome Treatment
1 17 YR Other (B)(4) IMPLANTABLE PACEMAKER/CARDIO/DEFIB| 4968 IMPLANTABLE PACING LEAD