FDA Adverse Event Malfunction Summary report: N

TELIGEN

MDR report key: 3041166 · Received April 8, 2013

Report

Report Number
2124215-2013-01824
Event Type
Malfunction
Date Received
April 8, 2013
Date of Event
January 16, 2013
Report Date
April 1, 2013
Manufacturer
GUIDANT CRM CLONMEL IRELAND
Product Code
LWP
Removal / Correction Number
Z-0026-2014
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE INVESTIGATION OF THIS EVENT IS ONGOING. AWAITING RESULTS OF THE DEVICE FOLLOW-UP AND RETURN OF A MEMORY UPLOAD FOR ANALYSIS. TO DATE, A MEMORY UPLOAD HAS NOT BEEN RETURNED. UPON RECEIPT, THE DEVICE WILL UNDERGO DETAILED LABORATORY TESTING TO DETERMINE ROOT CAUSE.

Additional Manufacturer Narrative · 1

(B)(4). BOSTON SCIENTIFIC HAS ISSUED AN ADVISORY COMMUNICATION REGARDING AN OLDER SUBSET OF COGNIS/TELIGEN DEVICES THAT IS MORE SUSCEPTIBLE TO THIS ANOMALY. SPECIFICALLY, THE PERFORMANCE OF A LOW VOLTAGE CAPACITOR MAY BE COMPROMISED OVER TIME, CAUSING AN INCREASED CURRENT DRAIN THAT CAN LEAD TO PREMATURE BATTERY DEPLETION. THIS PARTICULAR DEVICE WAS INCLUDED IN THE ADVISORY POPULATION.

Additional Manufacturer Narrative · 1

THE AVAILABLE INFORMATION SUGGESTS THAT THIS DEVICE REMAINS IN-SERVICE. THE INVESTIGATION OF THIS EVENT IS ON-GOING AS A REQUEST HAS BEEN MADE TO THE LOCAL REPRESENTATIVE FOR ADDITIONAL INFORMATION.

Additional Manufacturer Narrative · 1

UPON RECEIPT AT OUR QUALITY ASSURANCE LABORATORY, THIS DEVICE WAS THOROUGHLY INSPECTED AND ANALYZED. REVIEW OF THE DEVICE MEMORY CONFIRMED THAT A LOW VOLTAGE BATTERY FAULT (FAULT CODE 1003) HAD BEEN RECORDED. EXTERNAL VISUAL INSPECTION OF THE DEVICE NOTED TOOL MARKS ON THE FRONT OF THE DEVICE CASING JUST BELOW THE HEADER. AFTER THE TITANIUM CASE WAS OPENED, MICROSCOPIC VISUAL INSPECTION DID NOT REVEAL ANY IRREGULARITIES. THE BATTERY WAS THEN REMOVED, SO THAT AN EXTERNAL POWER SUPPLY COULD BE CONNECTED TO THE DEVICE FOR FURTHER ANALYSIS. A HIGHER THAN NORMAL CURRENT USAGE WAS OBSERVED. ELECTRICAL TESTING ISOLATED THE HIGH CURRENT CONDITION TO TWO COMPROMISED LOW VOLTAGE CAPACITORS THAT ARE CONNECTED TO THE DEVICE¿S BATTERY. THIS TYPE OF COMPONENT MALFUNCTION CAN RESULT IN A HIGH CURRENT DRAIN, WHICH OVER TIME CAN RESULT IN PREMATURE BATTERY DEPLETION, AS WAS OBSERVED IN THIS CASE.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS LOCAL REPRESENTATIVE WAS INFORMED BY THE PHYSICIAN THAT THIS DEVICE DISPLAYED A FAULT CODE#1003 (VOLTAGE TOO LOW FOR PROJECTED REMAINING CAPACITY). THE LOCAL REPRESENTATIVE CONTACTED BOSTON SCIENTIFIC'S TECHNICAL SERVICES (TS) AND THE ISSUE WAS DISCUSSED. TS SUGGESTED THAT A MEMORY UPLOAD COULD BE PERFORMED TO UNDERSTAND THE CONDITION OF THE DEPLETING BATTERY. ADDITIONALLY, THE LOCAL REPRESENTATIVE WAS INFORMED THAT THE DEVICE SHOULD BE EXPLANTED AND REPLACED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION FROM THE LOCAL REPRESENTATIVE THAT THIS PATIENT HAS BEEN SCHEDULED FOR A DEVICE FOLLOW-UP AT THE CLINIC IN (B)(6) 2013. THE PHYSICIAN IS AWARE OF THE RECOMMENDATION FOR DEVICE REPLACEMENT. THE LOCAL REPRESENTATIVE WILL PERFORM A MEMORY UPLOAD AT THE TIME OF THE DEVICE FOLLOW-UP IN (B)(6). SUBSEQUENTLY, BOSTON SCIENTIFIC RECEIVED INFORMATION FROM THE LOCAL REPRESENTATIVE THAT THE DEVICE WAS INTERROGATED AND ANOTHER FAULT CODE#1003 (VOLTAGE TOO LOW FOR PROJECTED REMAINING CAPACITY) WAS DISPLAYED. TS EMPHASIZED THAT THE DEVICE SHOULD BE EXPLANTED AND REPLACED. THE PATIENT WAS PRESENTED BACK TO THE EP LABORATORY. THE DEVICE WAS SUCCESSFULLY EXPLANTED AND REPLACED. THE DEVICE IS ENROUTE TO BOSTON SCIENTIFIC FOR LABORATORY TESTING.

Description of Event or Problem · 1

THE DEVICE WAS RECEIVED AT BOSTON SCIENTIFIC'S RETURN PRODUCTS DEPARTMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
143135 TELIGEN IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWP GUIDANT CRM CLONMEL IRELAND E110

Patients

Seq Age Sex Outcome Treatment
1 69 YR 4016| 0154| 1861| E110| T165