FDA Adverse Event Malfunction Summary report: N

LINOX SD 60/16

MDR report key: 3050243 · Received April 10, 2013

Report

Report Number
1028232-2013-00969
Event Type
Malfunction
Date Received
April 10, 2013
Date of Event
March 19, 2013
Report Date
April 2, 2013
Manufacturer
BIOTRONIK SE & CO. KG
Product Code
NVY
PMA / PMN Number
P980023
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS NOT RETURNED FOR ANALYSIS. THE ANALYSIS IS THEREFORE BASED ON THE INSPECTION OF THE QUALITY DOCUMENTS ASSOCIATED WITH THE MANUFACTURE OF THIS PARTICULAR DEVICE. THE MANUFACTURING PROCESS FOR THIS DEVICE WAS RE-INVESTIGATED. ALL PRODUCTION STEPS HAD BEEN PERFORMED ACCORDINGLY. THERE WAS NO SIGN OF ANY INCONSISTENCY DURING THE MANUFACTURING PROCESS WHICH MIGHT BE RELATED TO THE CLINICAL OBSERVATION. IN SUMMARY, THE DEVICE WAS NOT RETURNED FOR ANALYSIS. THE REVIEW OF THE QUALITY DOCUMENTS CONFIRMED A REGULAR DEVICE MANUFACTURING.

Description of Event or Problem · 1

THIS LEAD WAS CAPPED AND REPLACED DUE TO OVER-SENSING WITH NOISE WHICH CAUSED 38 INAPPROPRIATE SHOCKS. SHOULD ADDITIONAL INFORMATION BE RECEIVED, THIS FILE WILL BE UPDATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
148165 LINOX SD 60/16 ICD LEAD NVY BIOTRONIK SE & CO. KG 363303

Patients

Seq Age Sex Outcome Treatment
1 55 YR Hospitalization