FDA Adverse Event Malfunction Summary report: N

ALTRUA

MDR report key: 3053607 · Received April 11, 2013

Report

Report Number
2124215-2013-05267
Event Type
Malfunction
Date Received
April 11, 2013
Date of Event
March 21, 2013
Report Date
April 11, 2013
Manufacturer
GUIDANT CRM CLONMEL IRELAND
Product Code
NVZ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

UPON COMPLETION OF THE ANALYSIS, THIS EVENT WILL BE UPDATED.

Additional Manufacturer Narrative · 1

UPON RECEIPT AT OUR POST MARKET QUALITY ASSURANCE LABORATORY, A THOROUGH EVALUATION OF THE DEVICE WAS PERFORMED. A VISUAL INSPECTION OF THE DEVICE HEADER AND CASE NOTED NO ANOMALIES. THE DEVICE WAS THEN EXPOSED TO SIMULATED HEART LOAD CONDITIONS, AND THE PACING AND SENSING FUNCTIONS WERE TESTED. THE DEVICE OPERATED APPROPRIATELY, ACCORDING TO ITS PERFORMANCE SPECIFICATIONS, WITH NO INTERRUPTIONS IN THERAPY OUTPUT OR PROGRAMMER COMMUNICATION AT THE RETURNED PROGRAMMED SETTINGS. A SERIES OF ELECTRICAL TESTS WAS ALSO PERFORMED, AND AGAIN, NORMAL DEVICE FUNCTION WAS OBSERVED. ANALYSIS CONCLUDED THE COMBINATION OF SHELF TIME, COOLER TEMPS AND BATTERY SIZE LINED UP TO POSSIBLY CAUSE THE INITIAL IDENTIFIED ISSUE.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS PRODUCT WAS RETURNED FROM OUR FINAL PACK AREA FOR ANALYSIS AS THE PRODUCT HAD NOT PASSED ALL REQUIRED TESTING. FURTHER ANALYSIS WILL BE PERFORMED.

Description of Event or Problem · 1

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Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
156623 ALTRUA IMPLANTABLE PULSE GENERATOR NVZ GUIDANT CRM CLONMEL IRELAND S603

Patients

Seq Age Sex Outcome Treatment
1