FDA Adverse Event Injury Summary report: N

ENRHYTHM

MDR report key: 3152952 · Received June 8, 2013

Report

Report Number
9614453-2013-01104
Event Type
Injury
Date Received
June 8, 2013
Date of Event
March 6, 2013
Report Date
March 6, 2013
Manufacturer
IPG MFG SWITZERLAND
Product Code
NVZ
PMA / PMN Number
P980035
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS EVENT OCCURRED OUTSIDE THE US WHERE THE SAME MODEL IS DISTRIBUTED. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. PATIENT INFORMATION IS NOT GENERALLY AVAILABLE DUE TO CONFIDENTIALITY CONCERNS. CONCOMITANT PRODUCTS: 5554-53, IMPLANTABLE PACING LEAD, (B)(6) 1999; 5054-58, IMPLANTABLE PACING LEAD, (B)(6) 1999. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT AN ELECTRICAL RESET OCCURRED IN THE DEVICE. THE DEVICE WAS INTERROGATED AND 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
258229 ENRHYTHM PULSE GENERATOR, PERMANENT, IMPLANTABLE NVZ IPG MFG SWITZERLAND P1501DR

Patients

Seq Age Sex Outcome Treatment
1 00075 YR Required Intervention