FDA Adverse Event Injury Summary report: N

FLEXTEND

MDR report key: 3041270 · Received April 8, 2013

Report

Report Number
2124215-2013-01814
Event Type
Injury
Date Received
April 8, 2013
Date of Event
January 16, 2013
Report Date
January 31, 2013
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION WAS RECEIVED THAT THIS LEAD WAS SURGICALLY ABANDONED AND A NEW LEAD IMPLANTED. THERE WERE NO ADDITIONAL ADVERSE PATIENT EFFECTS REPORTED.

Additional Manufacturer Narrative · 1

ALL AVAILABLE INFORMATION INDICATES THE DEVICE REMAINS IN SERVICE. THIS INVESTIGATION WILL BE UPDATED SHOULD FURTHER INFORMATION BE PROVIDED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS RIGHT VENTRICULAR (RV) LEAD EXHIBITED A HIGH OUT OF RANGE PACING IMPEDANCE AND THE THRESHOLDS HAVE RISEN. SOME OVERSENSING WAS ALSO NOTED. THE PHYSICIAN WILL ADDRESS THE ISSUE IN THE COMING DAYS.THE PATIENT IS NOT PACER DEPENDENT. THERE WERE NO ADVERSE PATIENT EFFECTS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
142790 FLEXTEND IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4087

Patients

Seq Age Sex Outcome Treatment
1 86 YR Hospitalization| L| R S606| 1290| 4086| 4087