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