FDA Adverse Event Injury Summary report: N

VIRTUOSO DR

MDR report key: 2951707 · Received February 9, 2013

Report

Report Number
3004209178-2013-01581
Event Type
Injury
Date Received
February 9, 2013
Report Date
November 5, 2012
Manufacturer
MEDTRONIC MED REL MEDTRONIC PUERTO RICO
Product Code
LWS
PMA / PMN Number
P980016/S062
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
DE, 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. PRODUCT EVENT SUMMARY: THE DEVICE WAS RETURNED AND ANALYZED. A HIGH CURRENT DRAIN CONDITION WAS FOUND DURING DEVICE ANALYSIS. ELECTRICAL ANALYSIS FOUND THE CAUSE OF THE HIGH CURRENT DRAIN TO BE CURRENT LEAKAGE IN THE BATTERY FILTER CAPACITORS. (B)(4). CONCOMITANT MEDICAL PRODUCTS: IMPLANTABLE TACHY LEAD: (B)(6) 1998.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE LONGEVITY WAS LESS THAN FIVE YEARS. 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
56385 VIRTUOSO DR DEFIBRILLATOR, AUTOMATIC IMPLANTABLE CARDIOVERTER LWS MEDTRONIC MED REL MEDTRONIC PUERTO RICO D154AWG

Patients

Seq Age Sex Outcome Treatment
1 00066 YR Hospitalization| R 6945 IMPLANTABLE TACHY LEAD