FDA Adverse Event Injury Summary report: N

THINLINE

MDR report key: 3212423 · Received July 9, 2013

Report

Report Number
2124215-2013-09292
Event Type
Injury
Date Received
July 9, 2013
Date of Event
May 20, 2013
Report Date
May 20, 2013
Manufacturer
GUIDANT ANGLETON/ST. PAUL
Product Code
NVN
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

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 AND EROSION. THERE WERE NO ADDITIONAL ADVERSE EFFECTS REPORTED. THE PRODUCT WAS EXPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
312479 THINLINE IMPLANTABLE LEAD NVN GUIDANT ANGLETON/ST. PAUL 438-10

Patients

Seq Age Sex Outcome Treatment
1 10839 DA Hospitalization| L| R 438-10