FDA Adverse Event Injury Summary report: N

ATTAIN ABILITY PLUS

MDR report key: 3152528 · Received June 7, 2013

Report

Report Number
2649622-2013-06762
Event Type
Injury
Date Received
June 7, 2013
Report Date
April 23, 2013
Manufacturer
MPRI
Product Code
OJX
PMA / PMN Number
P080006
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

PRODUCT EVENT SUMMARY: PRODUCT ID# 429688 THE FULL LEAD WAS RETURNED. ANALYSIS WAS PERFORMED AND NO ANOMALIES WERE FOUND.

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. CONCOMITANT MEDICAL PRODUCTS: 5076-58, IMPLANTABLE PACING LEAD, (B)(6) 2011; C2TR01, IMPLANTABLE PULSE GENERATOR (IPG), 2011; 6570, STENT, (B)(6) 1998; 6575, STENT, (B)(6) 1998. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT HAD A SYSTEMIC INFECTION. THE DEVICE AND LEADS WERE EXPLANTED AND LATER REPLACED. NO FURTHER PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
253080 ATTAIN ABILITY PLUS DRUG ELUTING PERMANENT LEFT VENTRICULAR (LV) PACEMAKER ELECTRODE OJX MPRI 429688

Patients

Seq Age Sex Outcome Treatment
1 00086 YR Hospitalization| R