FDA Adverse Event Injury Summary report: N

TRANSVENE

MDR report key: 2951802 · Received February 9, 2013

Report

Report Number
2649622-2013-00241
Event Type
Injury
Date Received
February 9, 2013
Date of Event
November 12, 2012
Report Date
November 12, 2012
Manufacturer
MPRI
Product Code
LWS
PMA / PMN Number
P920015/S039
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT: 1156T IMPLANTABLE PACING LEAD (B)(6) 2012. THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THERE WAS T-WAVE OVERSENSING. THE SENSING WAS PROGRAMMED TRUE BIPOLAR AND AND INTEGRATED BIPOLAR. THERE WAS STILL T-WAVE OVERSENSING AT .9MV. THE BLANKING WAS EXTENDED BUT T-WAVE OVERSENSING CONTINUED. THE LEAD REMAINS 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
57585 TRANSVENE DEFIBRILLATOR, AUTOMATIC IMPLANTABLE CARDIOVERTER LWS MPRI 693565

Patients

Seq Age Sex Outcome Treatment
1 00076 YR Required Intervention (B)(4) BIVENTRICULAR DEFIBRILLATOR