FDA Adverse Event Malfunction Summary report: N

VITALITY 2

MDR report key: 3043286 · Received April 9, 2013

Report

Report Number
2124215-2013-02105
Event Type
Malfunction
Date Received
April 9, 2013
Date of Event
October 15, 2012
Report Date
February 7, 2013
Manufacturer
GUIDANT CRM CLONMEL IRELAND
Product Code
LWS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MD
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

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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.

Additional Manufacturer Narrative · 1

UPON RECEIPT AT OUR POST MARKET QUALITY ASSURANCE LABORATORY, A REVIEW OF DEVICE MEMORY REVEALED THAT THE DEVICE DECLARED ELECTIVE REPLACEMENT INDICATOR (ERI) AFTER EXPERIENCING TWO CONSECUTIVE CHARGE TIMES GREATER THAN THE EXTENDED MID-LIFE ERI CHARGE TIME LIMIT. THE OBSERVED RATE OF BATTERY USAGE WAS COMPARED TO THE EXPECTED RATE OF BATTERY USAGE; THE RESULTS INDICATED THAT THE MONITORING VOLTAGE WAS NORMAL. ALTHOUGH THE BATTERY ITSELF HAD NOT DEPLETED PREMATURELY, ERI WAS TRIGGERED EARLIER THAN EXPECTED BY EXTENDED CHARGE TIMES DUE TO A HIGHER-THAN-TYPICAL BUILDUP OF INTERNAL BATTERY IMPEDANCE.

Description of Event or Problem · 1

ADDITIONAL INFORMATION WAS RECEIVED THAT THIS DEVICE WAS EXPLANTED. NO ADVERSE PATIENT EFFECTS WERE REPORTED DURING THE PROCEDURE. THE DEVICE WAS RETURNED TO ALLOW FOR RELIABILITY ANALYSIS.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS DEVICE DECLARED ELECTIVE REPLACEMENT INDICATOR (ERI) WITH INCREASED CHARGE TIME MEASUREMENTS. THE PATIENT WAS TO BE SCHEDULED FOR A DEVICE CHANGE OUT PROCEDURE. TO DATE, NO ADVERSE PATIENT EFFECTS WERE REPORTED AS A RESULT OF THIS CLINICAL OBSERVATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
145988 VITALITY 2 IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS GUIDANT CRM CLONMEL IRELAND T177

Patients

Seq Age Sex Outcome Treatment
1 72 YR T177| 0158| 1790