FDA Adverse Event Malfunction Summary report: N

SPRINT QUATTRO SECURE

MDR report key: 3153725 · Received June 8, 2013

Report

Report Number
2649622-2013-06171
Event Type
Malfunction
Date Received
June 8, 2013
Report Date
April 3, 2013
Manufacturer
MPRI
Product Code
LWS
PMA / PMN Number
P920015
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
PHYSICIAN

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. PRODUCT EVENT SUMMARY: THE LEAD WAS NOT RETURNED FOR ANALYSIS. HOWEVER, PERFORMANCE DATA COLLECTED FROM THE DEVICE WAS RECEIVED AND ANALYZED. ANALYSIS REVEALED THAT THERE WAS HIGH SUPERIOR VENA CAVA (SVC) DEFIBRILLATION (DEFIB) IMPEDANCE. THERE WERE THREE PATIENT ALERTS FOR OUT OF TOLERANCE (OOT) SUBTHRESHOLD LEAD IMPEDANCE BETWEEN (B)(6) 2013. THE WEEKLY HV (HIGH VOLTAGE) LEAD TREND DATA SHOWS AN INCREASE FOR MIN AND MAX SVC DEFIB EQUAL TO 59 TO 13 ,136 OHMS RANGE BETWEEN (B)(6) 2012 AND (B)(6) 2013. CONCOMITANT PRODUCTS: 507645 IMPLANTABLE PACING LEAD - (B)(6) 2007. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE RIGHT VENTRICULAR LEAD IS SUSPECTED TO BE FRACTURED AS THE LEAD'S SUPERIOR VENA CAVA (SVC) IMPEDANCE HAS BEEN TRENDING UPWARDS AND HAS CONSISTENTLY MEASURED HIGH OVER THE LAST FOURTEEN DAYS. THE LEAD REMAINS IN USE AS THE PHYSICIAN PLANS TO PERFORM VENTRICULAR FIBRILLATION (VF) INDUCTION TESTING. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
254950 SPRINT QUATTRO SECURE DEFIBRILLATOR, AUTOMATIC IMPLANTABLE CARDIOVERTER LWS MPRI 694758

Patients

Seq Age Sex Outcome Treatment
1 00065 YR D154AWG IMPLANTABLE PACEMAKER/CARDIO/DEFIB