FDA Adverse Event
Injury
Summary report: N
CURRENT PLUS DR
MDR report key: 3210691
·
Received July 8, 2013
Report
- Report Number
- 2938836-2013-03370
- Event Type
- Injury
- Date Received
- July 8, 2013
- Date of Event
- May 3, 2013
- Manufacturer
- ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
- Product Code
- LWS
- PMA / PMN Number
- P910023
- Removal / Correction Number
- NA
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NH
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
Narratives
Additional Manufacturer Narrative · 1
ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED.
Description of Event or Problem · 1
IT WAS REPORTED THAT AN ASYMPTOMATIC PATIENT PRESENTED IN THE ER AFTER RECEIVING INAPPROPRIATE ATP AND HV THERAPY. STORED EGMS SHOWED ATRIAL FIBRILLATION WITH A RAPID VENTRICULAR RESPONSE. THE DEVICE WAS REPROGRAMMED AND PATIENT WILL BE MONITORED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 310398 | CURRENT PLUS DR | IMPLANTABLE CARDIOVERTER DEFIBRILLATOR | LWS | ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION | CD2211-36 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 60 YR | Required Intervention |