FDA Adverse Event Injury Summary report: N

SPECTRAFLEX

MDR report key: 3152576 · Received June 7, 2013

Report

Report Number
6000023-2013-00019
Event Type
Injury
Date Received
June 7, 2013
Report Date
April 24, 2013
Manufacturer
MEDTRONIC, B.V.
Product Code
DTB
PMA / PMN Number
K790429
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE RIGHT VENTRICULAR (RV) LEAD HAD LOW THRESHOLD. IT WAS ALSO REPORTED THAT PROGRAMMED VOLTAGE WHAT INCREASED, HOWEVER THAT CREATED SOME POCKET STIMULATION. THEREFORE VENTRICULAR CAPTURE MANAGEMENT (VCM) WAS PROGRAMMED OFF AND PROGRAMMED VOLTAGE ADJUSTED STILL LEAVING A GOOD SAFETY MARGIN FOR THE PATIENT WITH HIGH THRESHOLD. THE RV LEAD REMAINS IN USE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
252083 SPECTRAFLEX ELECTRODE, PACEMAKER, PERMANENT DTB MEDTRONIC, B.V. 6957

Patients

Seq Age Sex Outcome Treatment
1 00088 YR Life Threatening| R ADSR06 IMPLANTABLE PACEMAKER