FDA Adverse Event Malfunction Summary report: N

SELUTE PICOTIP

MDR report key: 3043183 · Received April 9, 2013

Report

Report Number
2124215-2013-01876
Event Type
Malfunction
Date Received
April 9, 2013
Date of Event
January 23, 2013
Report Date
January 23, 2013
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE THIS INVESTIGATION WILL BE UPDATED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT DURING A FOLLOW UP THE PATIENT PRESENTED WITH ATRIAL FIBRILLATION. INTERMITTENT UNDERSENSING OF THE ATRIAL SIGNAL WAS NOTED. THE LEAD IMPEDANCES WAS LOW AND INSULATION DAMAGE WAS SUSPECTED. THE DEVICE WAS REPROGRAMMED. NO FURTHER ACTION WAS PLANNED. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
144998 SELUTE PICOTIP IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4064

Patients

Seq Age Sex Outcome Treatment
1