BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    TELIGEN

    MDR report key: 3043327 · Received April 9, 2013

    Report

    Report Number
    2124215-2013-02722
    Event Type
    Malfunction
    Date Received
    April 9, 2013
    Date of Event
    January 17, 2013
    Report Date
    January 22, 2013
    Manufacturer
    GUIDANT CRM CLONMEL IRELAND
    Product Code
    LWS
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    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 THAT THIS PATIENT'S HOME MONITORING SYSTEM DETECTED A LOW, OUT-OF-RANGE (OOR), SHOCK LEAD IMPEDANCE FOR THIS RIGHT VENTRICULAR (RV) LEAD AND IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (ICD) SYSTEM. THE FIELD REPRESENTATIVE CALLED TO REVIEW THE INFORMATION WITH BOSTON SCIENTIFIC TECHNICAL SERVICES (TS) AND IT WAS DISCUSSED THAT THE IMPEDANCE MEASUREMENT WAS 0 OHMS AND ALL OTHERS HAVE BEEN IN THE 40-50 OHM RANGE. IT WAS ANTICIPATED THAT THE PATIENT WOULD BE SEEN FOR EVALUATION. THE PATIENT WAS SEEN FOR CLINICAL EVALUATION AND IT WAS NOTED THAT THE EVALUATION WAS FINE. NO ADVERSE PATIENT EFFECTS WERE REPORTED. THE SYSTEM REMAINS IN SERVICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    145591 TELIGEN IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS GUIDANT CRM CLONMEL IRELAND E110

    Patients

    Seq Age Sex Outcome Treatment
    1 73 YR 1861| 5068| (B)(4)| E110| T165| 0154