FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 3043078 · Received April 9, 2013

Report

Report Number
2124215-2013-01354
Event Type
Injury
Date Received
April 9, 2013
Date of Event
January 17, 2013
Report Date
March 26, 2013
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

UPON RECEIPT OF FURTHER INFORMATION, THIS EVENT WILL BE UPDATED.

Additional Manufacturer Narrative · 1

AS NO FURTHER INFORMATION CONCERNING THIS REPORT IS EXPECTED, OUR INVESTIGATION IS COMPLETE. THIS INVESTIGATION WILL BE UPDATED SHOULD FURTHER INFORMATION BE PROVIDED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THE PATIENT WITH THIS RIGHT VENTRICULAR LEAD WAS HOSPITALIZED. TELEMETRY REVEALED LOSS OF CAPTURE RESULTING IN A PRESYNCOPAL EPISODE. INTERROGATION REVEALED AN INTERMITTENT LEAD FRACTURE. A REVISION PROCEDURE IS INTENDED. NO FURTHER PATIENT SYMPTOMS WERE REPORTED.

Description of Event or Problem · 1

SUBSEQUENTLY A REVISION PROCEDURE WAS PERFORMED. THIS LEAD WAS SURGICALLY ABANDONED AND REPLACED.

Description of Event or Problem · 1

ADDITIONAL INFORMATION WAS OBTAINED. THIS LEAD HAD ALSO DISPLAYED NOISE AND INCREASED THRESHOLD MEASUREMENTS. WHEN THE REVISION HAD BEEN PERFORMED, THERE WAS NO VISUAL OBSERVATION OF A LEAD FRACTURE. THE PATIENT WITH THIS LEAD IS NOT PACEMAKER DEPENDENT. REPROGRAMMING THE DEVICE TO MAXIMUM OUTPUTS HAD NOT RESOLVED THE ISSUE. UPON OPENING THE POCKET, NO VISUAL INSPECTION OF EXPOSED SECTION OF THE LEAD DID NOT REVEAL ANY LEAD FRACTURE. THE DEVICE WAS ALSO REPLACED AS IT HAD BEEN IMPLANTED APPROXIMATELY SEVEN YEARS. THIS LEAD WAS SURGICALLY ABANDONED AND THERE WAS NO INTENDED DEVICE RETURN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
147346 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4457

Patients

Seq Age Sex Outcome Treatment
1 84 YR Hospitalization| L| R