FDA Adverse Event Injury Summary report: N

ATLAS II PLUS DR

MDR report key: 3090073 · Received May 2, 2013

Report

Report Number
2938836-2013-01288
Event Type
Injury
Date Received
May 2, 2013
Date of Event
February 4, 2013
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
LWS
PMA / PMN Number
P910023
Removal / Correction Number
NA
Adverse Event
Yes
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 THE REPORTED PREMATURE BATTERY DEPLETION WAS NOT CONFIRMED. A LONGEVITY CALCULATION WAS PERFORMED BASED ON PROGRAMMED SETTINGS AND USAGE DATA AND THE DEVICE WAS FOUND TO MEET ITS LONGEVITY REQUIREMENT. THE DEVICE WAS ANALYZED ON THE BENCH AND ALL SPECIFICATIONS WERE MET. NO ANOMALIES WERE DETECTED THE DEVICE WAS FOUND TO BE NORMAL IN THE LABORATORY.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE WAS EXPLANTED DUE TO PREMATURE ERI AND INAPPROPRIATE SHOCKS. THE PATIENT IS A TWIDDLER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
191929 ATLAS II PLUS DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION V-268 NA

Patients

Seq Age Sex Outcome Treatment
1 72 YR Required Intervention