FDA Adverse Event Malfunction Summary report: N

UNIFY CRT-D

MDR report key: 3080239 · Received April 26, 2013

Report

Report Number
2938836-2013-01014
Event Type
Malfunction
Date Received
April 26, 2013
Date of Event
February 20, 2013
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
NIK
PMA / PMN Number
P030054
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED.

Description of Event or Problem · 1

IT WAS REPORTED THAT INTERMITTENT T-WAVE OVERSENSING WAS OBSERVED. THE DEVICE WAS REPROGRAMMED AND WILL BE MONITORED. THERE WERE NO ADVERSE CONSEQUENCES AND THE PATIENTS CONDITION IS GOOD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
182387 UNIFY CRT-D IMPLANTABLE CARDIOVERTER DEFIBRILLATOR NIK ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION CD3235-40 NA

Patients

Seq Age Sex Outcome Treatment
1