FDA Adverse Event Injury Summary report: N

ENRHYTHM DR

MDR report key: 2813107 · Received October 31, 2012

Report

Report Number
6000144-2012-06136
Event Type
Injury
Date Received
October 31, 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
WV, 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 DEVICE WAS RETURNED, ANALYZED, AND CALCULATIONS BASED ON IMPLANT PARAMETERS INDICATE THAT THE DEVICE HAD MET ITS 99.9% EXPECTED LONGEVITY. ANALYSIS OF THE DEVICE MEMORY FOUND THE ERI (ELECTIVE REPLACEMENT INDICATOR) IS THE RESULT OF HIGH INTERNAL BATTERY IMPEDANCE. THIS DEVICE IS PART OF THE FIELD ACTION AND HAS TESTED CONSISTENT WITH THE FIELD ACTION.

Description of Event or Problem · 1

IT WAS REPORTED THAT A "BIG DROP" IN BATTERY VOLTAGE WAS SEEN BETWEEN THE PATIENT'S (B)(6) VISIT AND (B)(6) WHEN THE ELECTIVE REPLACEMENT INDICATOR WAS TRIGGERED. THE DEVICE WAS EXPLANTED 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 ENRHYTHM DR IMPLANTABLE PULSE GENERATOR DXY MEDTRONIC MED REL, INC. P1501DR

Patients

Seq Age Sex Outcome Treatment
1 76 YR Hospitalization| R 5076 X2 IMPLANTABLE PACING LEAD