FDA Adverse Event Malfunction Summary report: N

ATLAS PLUS VR

MDR report key: 2984428 · Received February 28, 2013

Report

Report Number
2938836-2013-00600
Event Type
Malfunction
Date Received
February 28, 2013
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
LWS
PMA / PMN Number
P910023
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE REPORTED NO COMMUNICATION WAS CONFIRMED AND WAS DUE TO A LOW BATTERY VOLTAGE. A LONGEVITY CALCULATION WAS PERFORMED AND FOUND TO BE BELOW THE EXPECTED LIMITS. THE DEVICE WAS TESTED MANUALLY ON THE BENCH AND USING AUTOMATED TEST EQUIPMENT; NO HIGH CURRENT DRAIN SOURCES WERE OBSERVED. THE ORIGINAL BATTERY WAS SENT TO THE VENDOR FOR FURTHER EVALUATION AND NO BATTERY ANOMALIES WERE DETECTED. THE CAUSE OF THE PREMATURE BATTERY DEPLETION COULD NOT BE DETERMINED.

Additional Manufacturer Narrative · 1

NO MEDWATCH FORM WAS RECEIVED. DEVICE EVALUATION ANTICIPATED BUT NOT YET BEGUN.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING REGULAR FOLLOW UP IN (B)(6) 2012, THE DEVICE WAS UNABLE TO BE INTERROGATED. THE DEVICE WAS EXPLANTED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
87852 ATLAS PLUS VR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION V-193 NA

Patients

Seq Age Sex Outcome Treatment
1