FDA Adverse Event Injury Summary report: N

ATTAIN ABILITY PLUS

MDR report key: 3071706 · Received April 22, 2013

Report

Report Number
2649622-2013-05242
Event Type
Injury
Date Received
April 22, 2013
Report Date
February 7, 2013
Manufacturer
MPRI
Product Code
OJX
PMA / PMN Number
P080006
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. 5554 IMPLANTABLE PACING LEAD 2006 (B)(6); 6948 IMPLANTABLE TACHY LEAD 2006 (B)(6). (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE LEFT VENTRICULAR (LV) LEAD WAS EXHIBITING NON-CAPTURE POST-IMPLANT. A CHEST X-RAY CONFIRMED THE LEAD HAD DISLODGED. THE LEAD WAS EXPLANTED AND REPLACED WITH A NEW LV LEAD. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
171606 ATTAIN ABILITY PLUS DRUG ELUTING PERMANENT LEFT VENTRICULAR (LV) PACEMAKER ELECTRODE OJX MPRI 429688

Patients

Seq Age Sex Outcome Treatment
1 00072 YR Required Intervention (B)(4) IMPLANTABLE CARDIOVERTER DEFIBRILLATOR