FDA Adverse Event Injury Summary report: N

FLEXTEND II

MDR report key: 3210077 · Received July 8, 2013

Report

Report Number
2124215-2013-07496
Event Type
Injury
Date Received
July 8, 2013
Date of Event
April 18, 2013
Report Date
April 18, 2013
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

AS NO FURTHER INFORMATION CONCERNING THIS REPORT IS EXPECTED, OUR INVESTIGATION IS COMPLETE. THIS INVESTIGATION WILL BE UPDATED SHOULD FURTHER INFORMATION BE PROVIDED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS PRODUCT WAS PART OF A SYSTEM REVISION DUE TO INFECTION. THERE WERE NO ADDITIONAL ADVERSE EFFECTS REPORTED. THE PRODUCT WAS EXPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
311822 FLEXTEND II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4096

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| L| R