FDA Adverse Event Injury Summary report: N

TELIGEN

MDR report key: 2911812 · Received January 11, 2013

Report

Report Number
2124215-2012-16419
Event Type
Injury
Date Received
January 11, 2013
Date of Event
December 4, 2012
Report Date
January 27, 2014
Manufacturer
GUIDANT CRM CLONMEL IRELAND
Product Code
LWS
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

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Additional Manufacturer Narrative · 1

SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE THIS INVESTIGATION WILL BE UPDATED.

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION WAS RECEIVED WHICH NOTED THAT A REVISION TOOK PLACE TO UPGRADE TO A NEW DEVICE.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT DURING A REPLACEMENT PROCEDURE IN (B)(6) 2012, POST OPERATIVE TESTING SHOWED VARYING PACING IMPEDANCES AND SLIGHTLY HIGHER COMPARED TO IMPEDANCES WITH THE PREVIOUSLY IMPLANTED DEVICE. THE CONNECTION WAS CONFIRMED. POCKET MANEUVERS WERE PERFORMED WHICH SHOWED NO INTERFERENCE AND THE PACE/SENSE AMPLITUDES REMAINED SIMILAR TO THE PREVIOUSLY IMPLANTED DEVICE. TECHNICAL SERVICES ADVICE WAS REQUESTED. TECHNICAL SERVICES DISCUSSED THE VARYING IMPEDANCES OVER THE LIFE TIME OF THIS RIGHT VENTRICULAR LEAD. THE NEWLY IMPLANTED DEVICE AND LEAD REMAINED IMPLANTED. SUBSEQUENTLY, A FOLLOW UP TOOK PLACE 9 MONTHS LATER AND OUT OF RANGE PACING IMPEDANCES WERE NOTED ON THIS RIGHT VENTRICULAR LEAD. IT WAS NOTED THAT THE PACING IMPEDANCES WERE OUT OF RANGE FOR AT LEAST THREE MONTHS. NORMAL FOLLOW UPS WERE SCHEDULED. ALL OTHER VALUES APPEARED TO BE NORMAL SINCE THE IMPLANT PROCEDURE.

Description of Event or Problem · 1

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Description of Event or Problem · 1

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Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
17798 TELIGEN IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS GUIDANT CRM CLONMEL IRELAND F102

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| L| R 0175| 1870| F102