FDA Adverse Event Injury Summary report: N

DEXTRUS 4135

MDR report key: 2981080 · Received February 19, 2013

Report

Report Number
1028232-2013-00325
Event Type
Injury
Date Received
February 19, 2013
Date of Event
December 14, 2012
Report Date
February 6, 2013
Manufacturer
BIOTRONIK SE & CO. KG
Product Code
NVZ
PMA / PMN Number
P950037
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS NOT RETURNED FOR ANALYSIS. THE ANALYSIS IS THEREFORE BASED ON THE INSPECTION OF THE QUALITY DOCUMENTS ACCOMPANYING THIS PARTICULAR DEVICE. THE MANUFACTURING PROCESS FOR THIS DEVICE WAS RE-INVESTIGATED. ALL PRODUCT STEPS HAD BEEN PERFORMED ACCORDINGLY. THERE WAS NO SIGN OF ANY INCONSISTENCY DURING THE MANUFACTURING PROCESS, WHICH MIGHT BE RELATED TO THE CLINICAL OBSERVATION. IN SUMMARY, THE DEVICE WAS NOT RETURNED FOR ANALYSIS. THE REVIEW OF THE QUALITY DOCUMENTS CONFIRMED A REGULAR DEVICE MANUFACTURING.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS RIGHT ATRIAL LEAD WAS NO LONGER PACING OR SENSING APPROPRIATELY. AN X-RAY WAS PERFORMED AND THE LEAD APPEARED TO BE POINTING STRAIGHT DOWN. IT WAS NOTED THAT THE PATIENT WAS NOT SYMPTOMATIC. BOSTON SCIENTIFIC TECHNICAL SERVICES WAS CONSULTED REGARDING THIS AND RECOMMENDED REPOSITIONING OR REPLACING THE LEAD. NO ADVERSE PATIENT EFFECTS WERE REPORTED. OUR RECORDS INDICATE THIS LEAD REMAINS IMPLANTED. IF ADDITIONAL INFORMATION IS RECEIVED, THIS REPORT WILL BE UPDATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
72240 DEXTRUS 4135 PACER LEAD NVZ BIOTRONIK SE & CO. KG 358744

Patients

Seq Age Sex Outcome Treatment
1 UNK Hospitalization