BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CURRENT PLUS VR

    MDR report key: 3101115 · Received May 9, 2013

    Report

    Report Number
    2938836-2013-01900
    Event Type
    Injury
    Date Received
    May 9, 2013
    Date of Event
    February 19, 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 Location
    MO
    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 AN ASYMPTOMATIC PRESENTED IN CLINIC FOR A ROUTINE FOLLOW UP, INAPPROPRIATE THERAPY WAS OBSERVED DUE TO T-WAVE OVERSENSING. THE OVERSENSING WAS CONFIRMED ON A STORED EGM. IT WAS RECOMMENDED TO REPROGRAM THE DEVICE. NO FURTHER INFORMATION IS AVAILABLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    203951 CURRENT PLUS VR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION CD1211-36 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 66 YR