FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 3212525 · Received July 9, 2013

Report

Report Number
2124215-2013-09216
Event Type
Injury
Date Received
July 9, 2013
Date of Event
May 16, 2013
Report Date
June 13, 2013
Manufacturer
CPI - DEL CARIBE
Product Code
DTB
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
HI
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

UPON RECEIPT AT OUR POST MARKET QUALITY ASSURANCE LABORATORY, A THOROUGH EVALUATION OF THE LEAD WAS PERFORMED. RESISTANCE AND PRESSURE TESTS WERE COMPLETED TO ASSESS LEAD ELECTRICAL PERFORMANCE AND INSULATION INTEGRITY. MEASUREMENTS THROUGHOUT THESE TESTS WERE WITHIN NORMAL LIMITS. MICROSCOPIC INSPECTIONS OF THE TERMINAL PIN ASSEMBLY, LEAD BODY, AND ELECTRODE TIP FOUND NO ANOMALIES. LABORATORY TESTING WAS UNABLE TO REPRODUCE THE REPORTED CLINICAL OBSERVATIONS AND DETAILED ANALYSIS DID NOT REVEAL ANY ABNORMALITIES.

Additional Manufacturer Narrative · 1

THIS PRODUCT IS CURRENTLY UNDERGOING DETAILED ANALYSIS. THIS EVENT WILL BE UPDATED UPON COMPLETION OF ANALYSIS.

Description of Event or Problem · 1

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Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS RIGHT VENTRICULAR (RV) LEAD EXHIBITED LOSS OF CAPTURE, THE LEAD HAD DISLODGED SHORTLY AFTER IMPLANT. THE LEAD WAS EXPLANTED. THERE WERE NO ADDITIONAL ADVERSE PATIENT EFFECTS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
313688 FINELINE II IMPLANTABLE LEAD DTB CPI - DEL CARIBE 4470

Patients

Seq Age Sex Outcome Treatment
1 74 YR Hospitalization| L| R S606| 4470| 4469