FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 3213120 · Received July 9, 2013

Report

Report Number
2124215-2013-10459
Event Type
Injury
Date Received
July 9, 2013
Date of Event
June 14, 2013
Report Date
June 14, 2013
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NE
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 WAS SURGICALLY ABANDONED AND REPLACED DUE TO HIGH IMPEDANCES GREATER THAN 2000 OHMS AND ELEVATED CAPTURE THRESHOLDS. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
312253 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4474

Patients

Seq Age Sex Outcome Treatment
1 88 YR Hospitalization| L| R 4470| 4474| K173| 5076| 1297