FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 3211328 · Received July 8, 2013

Report

Report Number
2124215-2013-08656
Event Type
Injury
Date Received
July 8, 2013
Date of Event
May 7, 2013
Report Date
May 7, 2013
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA
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 RIGHT ATRIAL (RA) LEAD EXHIBITED OUT-OF-RANGE (OOR) IMPEDANCES OF GREATER THAN 2500 OHMS, AS WELL AS NOISE AND OVERSENSING. AS A RESULT THE LEAD WAS SURGICALLY ABANDONED AND SUCCESSFULLY REPLACED. TO DATE, NO ADDITIONAL ADVERSE PATIENT EFFECTS HAVE BEEN REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
309422 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4472

Patients

Seq Age Sex Outcome Treatment
1 48 YR Hospitalization| L| R 4472| S606| 4473