FDA Adverse Event Injury Summary report: N

TELIGEN

MDR report key: 3043231 · Received April 9, 2013

Report

Report Number
2124215-2013-01901
Event Type
Injury
Date Received
April 9, 2013
Date of Event
April 27, 2012
Report Date
February 5, 2020
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
LWP
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PO
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

WHEN ADDITIONAL INFORMATION BECOMES AVAILABLE, THIS EVENT WILL BE UPDATED.

Additional Manufacturer Narrative · 1

ACCORDING TO AVAILABLE INFORMATION, THIS DEVICE REMAINS IMPLANTED AND IN SERVICE. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE, THIS EVENT WILL BE UPDATED.

Additional Manufacturer Narrative · 1

THE PRODUCT HAS BEEN RECEIVED FOR ANALYSIS. THIS REPORT WILL BE UPDATED UPON COMPLETION OF ANALYSIS.

Additional Manufacturer Narrative · 1

THE PRODUCT HAS BEEN RECEIVED FOR ANALYSIS. THIS REPORT WILL BE UPDATED UPON COMPLETION OF ANALYSIS. THE RETURNED DEVICE WAS THOROUGHLY INSPECTED AND ANALYZED. A VISUAL INSPECTION OF THE DEVICE HEADER AND CASE NOTED NO ANOMALIES. ALL SEAL PLUGS WERE INTACT, SETSCREWS MOVED FREELY, AND SEAL RING MARKS INDICATED THE TERMINAL PIN WAS FULLY INSERTED INTO THE LEAD BARREL. PIN GAUGE TESTING, DESIGNED TO VERIFY PROPER PORT DIMENSIONS, WAS COMPLETED. EACH PORT MEASURED AS EXPECTED. THE DEVICE WAS THEN EXPOSED TO SIMULATED HEART LOAD CONDITIONS, AND THE DEFIBRILLATION, PACING, AND SENSING FUNCTIONS WERE TESTED. IMPEDANCE TESTING WAS COMPLETED AND ALL MEASUREMENTS WERE WITHIN NORMAL LIMITS. THE DEVICE OPERATED APPROPRIATELY WITH NO INTERRUPTIONS IN THERAPY OUTPUT AT THE RETURNED PROGRAMMED SETTINGS. A SERIES OF ELECTRICAL TESTS WAS ALSO PERFORMED, AND AGAIN, NORMAL DEVICE FUNCTION WAS OBSERVED. ANALYSIS DID NOT IDENTIFY ANY DEVICE CHARACTERISTICS THAT WOULD HAVE CAUSED OR CONTRIBUTED TO THE REPORTED NOISE AND IMPEDANCE ISSUES.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT A DEVICE REPLACEMENT PROCEDURE WAS PERFORMED. WHEN THIS CHRONIC RIGHT VENTRICULAR LEAD WAS RECONNECTED TO THE REPLACEMENT DEVICE, LEAD EVALUATION REVEALED STABLE MEASUREMENTS, HOWEVER SHOCK IMPEDANCE MEASUREMENTS HAD INCREASED FROM 69 OHMS TO GREATER THAN 125 OHMS. THIS LEAD WAS DISCONNECTED AND THE CONNECTOR PIN OF THE PROXIMAL AND DISTAL COIL WERE CLEANED AND REINSERTED TO ASSURE THERE WAS NOT A CONNECTION ISSUE. IN ADDITION BETADINE WAS INJECTED ON THE POCKET SITE. SIMILAR MEASUREMENTS WERE OBTAINED, HOWEVER THE FINAL MEASUREMENT WAS 69 OHMS. A DECISION WAS MADE TO LEAD THIS LEAD IMPLANTED. AN INTERNAL TECHNICAL SERVICE CONSULTANT WAS CONTACTED FOR ASSISTANCE. THIS DEVICE AND LEAD REMAINS IMPLANTED AND A SIX MONTH FOLLOW UP VISIT HAS BEEN SCHEDULED. NO ADVERSE PATIENT EFFECTS WERE REPORTED. APPROXIMATELY NINE MONTHS LATER, FOLLOW UP REVEALED HIGH OUT OF RANGE SHOCK IMPEDANCE MEASUREMENTS. IN ADDITION, NOISE WAS NOTED ON THE SHOCK ELECTROGRAM. A REVISION IS INTENDED IN THE FUTURE. THE PATIENT IS MONITORED REMOTELY.

Description of Event or Problem · 1

AN INTERNAL TECHNICAL SERVICE CONSULTANT REVIEWED THE DATA. IT WAS THOUGHT THERE MAY BE A LESS THAN OPTIMAL CONNECTION AS THERE WAS NOISE ON THE SHOCK CHANNEL UNRELATED TO MYOPOTENTIALS. REMOTE MONITORING REVEALED ONE NON-SUSTAINED EPISODE HAD BEEN STORED AND NO ARTIFACTS WERE NOTED ON THE SHOCK LEAD OR RV LEAD. A HIGH RESOLUTION X-RAY AND FURTHER LEAD INTEGRITY TESTING TO RULE OUT A POSSIBLE FRACTURE WAS FURTHER RECOMMENDED.

Description of Event or Problem · 1

ADDITIONAL INFORMATION WAS RECEIVED. REMOTE MONITORING REVEALED A FURTHER OUT OF RANGE SHOCK IMPEDANCE MEASUREMENT. THIS INFORMATION WAS PROVIDED TO THE PHYSICIAN.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT A DEVICE REPLACEMENT PROCEDURE WAS PERFORMED. WHEN THIS CHRONIC RIGHT VENTRICULAR LEAD WAS RECONNECTED TO THE REPLACEMENT DEVICE, LEAD EVALUATION REVEALED STABLE MEASUREMENTS, HOWEVER SHOCK IMPEDANCE MEASUREMENTS HAD INCREASED FROM 69 OHMS TO GREATER THAN 125 OHMS. THIS LEAD WAS DISCONNECTED AND THE CONNECTOR PIN OF THE PROXIMAL AND DISTAL COIL WERE CLEANED AND REINSERTED TO ASSURE THERE WAS NOT A CONNECTION ISSUE. IN ADDITION BETADINE WAS INJECTED ON THE POCKET SITE. SIMILAR MEASUREMENTS WERE OBTAINED, HOWEVER THE FINAL MEASUREMENT WAS 69 OHMS. A DECISION WAS MADE TO LEAD THIS LEAD IMPLANTED. AN INTERNAL TECHNICAL SERVICE CONSULTANT WAS CONTACTED FOR ASSISTANCE. THIS LEAD REMAINS IMPLANTED AND A SIX MONTH FOLLOW UP VISIT HAS BEEN SCHEDULED. NO ADVERSE PATIENT EFFECTS WERE REPORTED. APPROXIMATELY NINE MONTHS LATER, FOLLOW UP REVEALED HIGH OUT OF RANGE SHOCK IMPEDANCE MEASUREMENTS. IN ADDITION, NOISE WAS NOTED ON THE SHOCK ELECTROGRAM. A REVISION IS INTENDED IN THE FUTURE. THE PATIENT IS MONITORED REMOTELY. AN INTERNAL TECHNICAL SERVICE CONSULTANT REVIEWED THE DATA. IT WAS THOUGHT THERE MAY BE A LESS THAN OPTIMAL CONNECTION AS THERE WAS NOISE ON THE SHOCK CHANNEL UNRELATED TO MYOPOTENTIALS. REMOTE MONITORING REVEALED ONE NON-SUSTAINED EPISODE HAD BEEN STORED AND NO ARTIFACTS WERE NOTED ON THE SHOCK LEAD OR RV LEAD. A HIGH RESOLUTION X-RAY AND FURTHER LEAD INTEGRITY TESTING TO RULE OUT A POSSIBLE FRACTURE WAS FURTHER RECOMMENDED. ADDITIONAL INFORMATION WAS RECEIVED. REMOTE MONITORING REVEALED A FURTHER OUT OF RANGE SHOCK IMPEDANCE MEASUREMENT. THIS INFORMATION HAS BEEN PROVIDED TO THE PHYSICIAN. ADDITIONAL INFORMATION WAS RECEIVED THAT A SYSTEM REVISION WAS PERFORMED. THE IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (ICD) WAS EXPLANTED AND THE RIGHT VENTRICULAR (RV) LEAD WAS SURGICALLY ABANDONED. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT A DEVICE REPLACEMENT PROCEDURE WAS PERFORMED. WHEN THIS CHRONIC RIGHT VENTRICULAR LEAD WAS RECONNECTED TO THE REPLACEMENT DEVICE, LEAD EVALUATION REVEALED STABLE MEASUREMENTS, HOWEVER SHOCK IMPEDANCE MEASUREMENTS HAD INCREASED FROM 69 OHMS TO GREATER THAN 125 OHMS. THIS LEAD WAS DISCONNECTED AND THE CONNECTOR PIN OF THE PROXIMAL AND DISTAL COIL WERE CLEANED AND REINSERTED TO ASSURE THERE WAS NOT A CONNECTION ISSUE. IN ADDITION BETADINE WAS INJECTED ON THE POCKET SITE. SIMILAR MEASUREMENTS WERE OBTAINED, HOWEVER THE FINAL MEASUREMENT WAS 69 OHMS. A DECISION WAS MADE TO LEAVE THIS LEAD IMPLANTED. AN INTERNAL TECHNICAL SERVICE CONSULTANT WAS CONTACTED FOR ASSISTANCE. THIS LEAD REMAINS IMPLANTED AND A SIX MONTH FOLLOW UP VISIT HAS BEEN SCHEDULED. NO ADVERSE PATIENT EFFECTS WERE REPORTED. APPROXIMATELY NINE MONTHS LATER, FOLLOW UP REVEALED HIGH OUT OF RANGE SHOCK IMPEDANCE MEASUREMENTS. IN ADDITION, NOISE WAS NOTED ON THE SHOCK ELECTROGRAM. A REVISION IS INTENDED IN THE FUTURE. THE PATIENT IS MONITORED REMOTELY. AN INTERNAL TECHNICAL SERVICE CONSULTANT REVIEWED THE DATA. IT WAS THOUGHT THERE MAY BE A LESS THAN OPTIMAL CONNECTION AS THERE WAS NOISE ON THE SHOCK CHANNEL UNRELATED TO MYOPOTENTIALS. REMOTE MONITORING REVEALED ONE NON-SUSTAINED EPISODE HAD BEEN STORED AND NO ARTIFACTS WERE NOTED ON THE SHOCK LEAD OR RV LEAD. A HIGH RESOLUTION X-RAY AND FURTHER LEAD INTEGRITY TESTING TO RULE OUT A POSSIBLE FRACTURE WAS FURTHER RECOMMENDED. ADDITIONAL INFORMATION WAS RECEIVED. REMOTE MONITORING REVEALED A FURTHER OUT OF RANGE SHOCK IMPEDANCE MEASUREMENT. THIS INFORMATION HAS BEEN PROVIDED TO THE PHYSICIAN. ADDITIONAL INFORMATION WAS RECEIVED THAT A SYSTEM REVISION WAS PERFORMED. THE IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (ICD) WAS EXPLANTED AND THE RIGHT VENTRICULAR (RV) LEAD WAS SURGICALLY ABANDONED. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
145180 TELIGEN IMPLANTABLE PULSE GENERATOR, PACEMAKER (NON-CRT) LWP BOSTON SCIENTIFIC CORPORATION F102 115175

Patients

Seq Age Sex Outcome Treatment
1 49 YR Hospitalization| L| R 1852| 1793| 0125| F102