FDA Adverse Event Malfunction Summary report: N

ATTAIN ABILITY PLUS

MDR report key: 3153743 · Received June 8, 2013

Report

Report Number
2649622-2013-06194
Event Type
Malfunction
Date Received
June 8, 2013
Date of Event
April 8, 2013
Report Date
April 8, 2013
Manufacturer
MPRI
Product Code
OJX
PMA / PMN Number
P080006
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OK, 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. (B)(4).

Additional Manufacturer Narrative · 1

PRODUCT EVENT SUMMARY: THE FULL LEAD WAS RETURNED, ANALYZED, AND NO ANOMALIES WERE FOUND.

Additional Manufacturer Narrative · 1

CORRECTED INFORMATION: NO EVAL EXPLAIN CODE. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING THE IMPLANT ATTEMPT, A LEFT VENTRICULAR LEAD HAD HIGH THRESHOLD. THE PHYSICIAN REFERRED THE PATIENT FOR EPICARDIAL LEADS WHICH WERE IMPLANTED THE FOLLOWING DAY. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
255075 ATTAIN ABILITY PLUS DRUG ELUTING PERMANENT LEFT VENTRICULAR (LV) PACEMAKER ELECTRODE OJX MPRI 429688

Patients

Seq Age Sex Outcome Treatment
1 00049 YR