FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 3211561 · Received July 8, 2013

Report

Report Number
2124215-2013-08139
Event Type
Injury
Date Received
July 8, 2013
Date of Event
May 14, 2013
Report Date
May 14, 2013
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE LEAD WAS SURGICALLY ABANDONED AND WILL NOT BE RETURNED FOR TESTING. THEREFORE, BOSTON SCIENTIFIC CANNOT CONFIRM THE REPORTED CLINICAL OBSERVATIONS. NO OTHER ADVERSE EVENTS HAVE BEEN REPORTED. THIS PRODUCT ISSUE WILL BE UPDATED IF ADDITIONAL INFORMATION IS RECEIVED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS ATRIAL LEAD WAS EXHIBITING IMPEDANCE MEASUREMENTS GREATER THAN 2000 OHMS. UNDERSENSING WAS ALSO OBSERVED. A LEAD REVISION WAS PERFORMED AND THE LEAD WAS REMOVED FROM SERVICE AND REPLACED. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
308697 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4469

Patients

Seq Age Sex Outcome Treatment
1 50 YR Hospitalization 4136| 4469| K173| 4456| S603