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 |