FDA Adverse Event Injury Summary report: N

FLEXTEND

MDR report key: 3212911 · Received July 9, 2013

Report

Report Number
2124215-2013-09585
Event Type
Injury
Date Received
July 9, 2013
Date of Event
June 10, 2013
Report Date
June 10, 2013
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KY
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 RIGHT VENTRICULAR (RV) LEAD WAS EXHIBITING IMPEDANCE MEASUREMENTS GREATER THAN 2000 OHMS, ELEVATED THRESHOLDS WITH NOISE AND OVERSENSING. A REVISION PROCEDURE WAS PERFORMED AND THE LEAD WAS REMOVED FROM SERVICE AND REPLACED WITHOUT FURTHER INCIDENT. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
314225 FLEXTEND IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4088

Patients

Seq Age Sex Outcome Treatment
1 94 YR Hospitalization| L 4088| 1190