FDA Adverse Event Injury Summary report: N

ATTAIN ABILITY PLUS

MDR report key: 2953513 · Received February 9, 2013

Report

Report Number
2649622-2013-01130
Event Type
Injury
Date Received
February 9, 2013
Date of Event
November 20, 2012
Report Date
November 20, 2012
Manufacturer
MPRI
Product Code
OJX
PMA / PMN Number
P080006
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AL, 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. (B)(4). CONCOMITANT PRODUCT 5076 IMPLANTABLE PACING LEAD (B)(6) 2011.

Description of Event or Problem · 1

IT WAS REPORTED A POCKET INFECTION OCCURRED. THE LEAD WAS REMOVED AND REPLACED. NO FURTHER PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
57326 ATTAIN ABILITY PLUS DRUG ELUTING PERMANENT LEFT VENTRICULAR (LV) PACEMAKER ELECTRODE OJX MPRI 429688

Patients

Seq Age Sex Outcome Treatment
1 00068 YR Hospitalization| R (B)(4) IMPLANTABLE PULSE GENERATOR