FDA Adverse Event Injury Summary report: N

SPRINT QUATTRO SECURE

MDR report key: 2955194 · Received February 11, 2013

Report

Report Number
2649622-2013-00839
Event Type
Injury
Date Received
February 11, 2013
Report Date
November 8, 2012
Manufacturer
MPRI
Product Code
LWS
PMA / PMN Number
P920015
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IT
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. ANALYSIS INDICATED OVERSENSING DUE TO NON-PHYSIOLOGIC SIGNALS/SENSING INTEGRITY COUNT (SIC) AND THE IMPEDANCE OF THE RIGHT VENTRICULAR (RV) PACING LEAD WAS BEYOND THE EXPECTED UPPER RANGE. THE ANALYST COMMENTED THAT 16 NONSUSTAINED VENTRICULAR TACHYCARDIA EVENTS OF LESS THAN 200 MILLISECONDS V-V INTERVAL OCCURRED BETWEEN (B)(6) 2007. THE MAXIMUM RV PACE WEEKLY VALUES ROSE TO A HIGH OF 1680 OHMS THE WEEK OF 2007-11-07 AND THE WEEKLY MAXIMUM RV PACE IMPEDANCES VARIED WIDELY BETWEEN THE WEEKS OF (B)(6) 2007 (448 OHMS UP TO 1424 OHMS).

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. THIS EVENT OCCURRED OUTSIDE OF THE US WHERE THE SAME MODEL IS DISTRIBUTED. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. PATIENT INFORMATION IS NOT GENERALLY AVAILABLE DUE TO CONFIDENTIALITY CONCERNS. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE RIGHT VENTRICULAR (RV) LEAD HAD A SUDDEN IMPEDANCE INCREASE, HIGH PACING IMPEDANCE, WAS EXHIBITING NOISE AND HAD AN INCREASED SENSING INTEGRITY COUNT (SIC). THE RV LEAD WAS REPLACED. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
59736 SPRINT QUATTRO SECURE DEFIBRILLATOR, AUTOMATIC IMPLANTABLE CARDIOVERTER LWS MPRI 6947

Patients

Seq Age Sex Outcome Treatment
1 00062 YR Hospitalization| R