FDA Adverse Event Malfunction Summary report: N

ATTAIN ABILITY PLUS

MDR report key: 2811594 · Received October 31, 2012

Report

Report Number
2649622-2012-16864
Event Type
Malfunction
Date Received
October 31, 2012
Date of Event
October 4, 2012
Manufacturer
MEDTRONIC PUERTO RICO, INC.
Product Code
OJX
PMA / PMN Number
P080006/S002
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, 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 (B)(4) - THE FULL LEAD WAS RETURNED AND ANALYZED AND NO ANOMALIES WERE FOUND. HOWEVER, ALL CONDUCTORS HAD BLOOD/BODY FLUID (NOT OBSTRUCTED). THE DISTAL CONDUCTOR HAD BLOOD/BODY FLUID (NOT OBSTRUCTED).

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING THE IMPLANT ATTEMPT, NOISE WAS NOTED. THE LEAD POSITIONING WAS ATTEMPTED SEVERAL TIMES. THE LEAD WAS NOT USED AND A NEW LEAD WAS IMPLANTED. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ATTAIN ABILITY PLUS IMPLANTABLE PACING LEAD OJX MEDTRONIC PUERTO RICO, INC. 4296

Patients

Seq Age Sex Outcome Treatment
1 69 YR Other