FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 3052625 · Received April 11, 2013

Report

Report Number
2124215-2013-04379
Event Type
Injury
Date Received
April 11, 2013
Date of Event
February 27, 2013
Report Date
February 27, 2013
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MD
Reporter Occupation
PHYSICIAN

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 THE RIGHT ATRIAL (RA) LEAD EXHIBITED UNDERSENSING AND PACING INHIBITON ALONG WITH HIGH OUT OF RANGE IMPEDANCE MEASUREMENTS. SUBSEQUENTLY THE LEAD WAS SURGICALLY ABANDONED DURING A DEVICE CHANGE OUT PROCEDURE. NO ADDITIONAL ADVERSE PAITENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
154419 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4472

Patients

Seq Age Sex Outcome Treatment
1 83 YR Hospitalization| L| R 0184| E141| T167| 4472