FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 3100537 · Received May 8, 2013

Report

Report Number
2124215-2013-07676
Event Type
Injury
Date Received
May 8, 2013
Date of Event
December 23, 2012
Report Date
May 14, 2013
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE LEAD REMAINS IN SERVICE. AS NO FURTHER INFORMATION CONCERNING THIS REPORT IS EXPECTED, OUR INVESTIGATION IS COMPLETE. THIS INVESTIGATION WILL BE UPDATED SHOULD FURTHER INFORMATION BE PROVIDED.

Additional Manufacturer Narrative · 1

IT WAS LATER REPORTED THAT THIS LEAD HAD EXHIBITED POOR SENSING AND INCREASED PACING THRESHOLD MEASUREMENTS. LEAD MIGRATION WAS NOTED, AND THEREFORE THE LEAD WAS REPOSITIONED. 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 THIS RIGHT VENTRICULAR (RV) LEAD WAS REPOSITIONED TWO DAYS POST-IMPLANT. THE REASON FOR THE LEAD REVISION WAS NOT PROVIDED. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
201926 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4471

Patients

Seq Age Sex Outcome Treatment
1 86 YR Hospitalization| L| R 4471