FDA Adverse Event Injury Summary report: N

SPRINT

MDR report key: 2952835 · Received February 9, 2013

Report

Report Number
2649622-2013-00721
Event Type
Injury
Date Received
February 9, 2013
Report Date
February 25, 2013
Manufacturer
MPRI
Product Code
LWS
PMA / PMN Number
P920015
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
ME, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

PRODUCT EVENT SUMMARY: THE LEAD WAS NOT RETURNED FOR ANALYSIS. HOWEVER, PERFORMANCE DATA COLLECTED FROM THE DEVICE WAS RECEIVED AND ANALYZED. IMPEDANCE/LOW IMPEDANCE: PATIENT ALERT FOR OOT SUBTHRESHOLD LEAD IMPEDANCE (B)(6) 2012 02:15:02. WEEKLY PACE IMPEDANCE TREND DATA SHOWS A GRADUAL DECREASE FOR MAX AND MIN RV PACE= 232 TO 188 OHMS MINIMUM BETWEEN (B)(6) 2012.

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. (B)(4).

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE RIGHT VENTRICULAR (RV) LEAD EXHIBITED LOW IMPEDANCES, OVERSENSING, AND NOISE. THE LEAD WAS CAPPED AND REPLACED. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE RIGHT VENTRICULAR (RV) LEAD EXHIBITED LOW IMPEDANCES, OVERSENSING, AND NOISE. THE LEAD WAS CAPPED 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
55918 SPRINT DEFIBRILLATOR, AUTOMATIC IMPLANTABLE CARDIOVERTER LWS MPRI 6945

Patients

Seq Age Sex Outcome Treatment
1 00064 YR Hospitalization| R (B)(4) IMPLANTABLE DEFIBRILLATOR