FDA Adverse Event Injury Summary report: N

LINOX SMART S DX 65/17

MDR report key: 3173916 · Received June 17, 2013

Report

Report Number
1028232-2013-01721
Event Type
Injury
Date Received
June 17, 2013
Date of Event
May 31, 2013
Report Date
June 3, 2013
Manufacturer
BIOTRONIK SE & CO. KG
Product Code
NVY
PMA / PMN Number
P980023
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS NOT RETURNED FOR ANALYSIS. THE ANALYSIS IS THEREFORE BASED ON THE INSPECTION OF THE QUALITY DOCUMENTS ASSOCIATED WITH THE MANUFACTURE OF THIS PARTICULAR DEVICE. THE MANUFACTURING PROCESS FOR THIS DEVICE WAS RE-INVESTIGATED. ALL PRODUCTION STEPS HAD BEEN PERFORMED ACCORDINGLY. THERE WAS NO SIGN OF ANY INCONSISTENCY DURING THE MANUFACTURING PROCESS WHICH MIGHT BE RELATED TO THE CLINICAL OBSERVATION. IN SUMMARY, THE DEVICE WAS NOT RETURNED FOR ANALYSIS. THE REVIEW OF THE QUALITY DOCUMENTS CONFIRMED A REGULAR DEVICE MANUFACTURING.

Description of Event or Problem · 1

THERE WAS A LEAD REVISION DONE DUE TO LOSS OF ATRIAL SENSING. THE LEAD SLACK WAS PULLED BACK TO THE DEVICE. THIS LEAD WAS REPOSITIONED AND REMAINS ACTIVELY IMPLANTED. THERE WERE NO ADVERSE PATIENT EVENTS REPORTED. SHOULD ADDITIONAL INFORMATION BE RECEIVED, THIS FILE WILL BE UPDATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
274450 LINOX SMART S DX 65/17 ICD LEAD NVY BIOTRONIK SE & CO. KG 365501

Patients

Seq Age Sex Outcome Treatment
1 49 YR Hospitalization