FDA Adverse Event Injury Summary report: N

ATTAIN ABILITY PLUS

MDR report key: 2813552 · Received October 31, 2012

Report

Report Number
2649622-2012-16539
Event Type
Injury
Date Received
October 31, 2012
Date of Event
September 25, 2012
Manufacturer
MEDTRONIC PUERTO RICO, INC.
Product Code
OJX
PMA / PMN Number
P080006/S002
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
ND, 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. NO ANOMALIES WERE FOUND. 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 THE PATIENT HAD TWIDDLER'S SYNDROME AND TWIDDLED ALL OF THE LEADS OUT OF PLACE. THE LEFT VENTRICULAR (LV) LEAD WAS EXPLANTED AND REPLACED. BOTH THE RIGHT VENTRICULAR (RV) AND RIGHT ATRIAL (RA) LEADS WERE REPOSITIONED AND REMAIN 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 ATTAIN ABILITY PLUS IMPLANTABLE PACING LEAD OJX MEDTRONIC PUERTO RICO, INC. 4296

Patients

Seq Age Sex Outcome Treatment
1 84 YR Hospitalization| R (B)(4) IMPLANTABLE PACEMAKER/CARDIO/DEFIB