FDA Adverse Event Injury Summary report: N

TELIGEN

MDR report key: 3213164 · Received July 9, 2013

Report

Report Number
2124215-2013-09834
Event Type
Injury
Date Received
July 9, 2013
Date of Event
June 4, 2013
Report Date
June 27, 2013
Manufacturer
GUIDANT CRM CLONMEL IRELAND
Product Code
LWS
Removal / Correction Number
Z-0088-2015
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). BOSTON SCIENTIFIC HAS ISSUED AN ADVISORY COMMUNICATION REGARDING AN OLDER SUBSET OF COGNIS/TELIGEN DEVICES THAT IS MORE SUSCEPTIBLE TO THIS ANOMALY. SPECIFICALLY, THE PERFORMANCE OF A LOW VOLTAGE CAPACITOR MAY BE COMPROMISED OVER TIME, CAUSING AN INCREASED CURRENT DRAIN THAT CAN LEAD TO PREMATURE BATTERY DEPLETION. THIS PARTICULAR DEVICE WAS INCLUDED IN THE ADVISORY POPULATION.

Additional Manufacturer Narrative · 1

FOLLOWING COMPLETION OF LAB ANALYSIS, THIS EVENT WILL BE FURTHER UPDATED.

Additional Manufacturer Narrative · 1

UPON RECEIPT AT OUR QUALITY ASSURANCE LABORATORY, THIS DEVICE WAS THOROUGHLY INSPECTED AND ANALYZED. REVIEW OF THE DEVICE MEMORY CONFIRMED TWO LOW VOLTAGE BATTERY FAULTS (FAULT CODE 1003) HAD BEEN RECORDED. EXTERNAL VISUAL INSPECTION OF THE DEVICE NOTED NO ANOMALIES INITIAL AUTOMATED TESTING VERIFIED BASIC SENSING, PACING AND SHOCKING FUNCTIONS OF THE DEVICE. AFTER THE TITANIUM CASE WAS OPENED, MICROSCOPIC VISUAL INSPECTION DID NOT REVEAL ANY IRREGULARITIES. THE BATTERY WAS THEN REMOVED, SO THAT AN EXTERNAL POWER SUPPLY COULD BE CONNECTED TO THE DEVICE FOR FURTHER ANALYSIS. A HIGHER THAN NORMAL CURRENT USAGE WAS OBSERVED. ELECTRICAL TESTING ISOLATED THE HIGH CURRENT CONDITION TO TWO COMPROMISED LOW VOLTAGE CAPACITORS THAT ARE CONNECTED TO THE DEVICE¿S BATTERY. THIS TYPE OF COMPONENT MALFUNCTION CAN RESULT IN A HIGH CURRENT DRAIN, WHICH OVER TIME CAN RESULT IN PREMATURE BATTERY DEPLETION, AS WAS OBSERVED IN THIS CASE.

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

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Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT DURING A ROUTINE INTERROGATION, THIS DEVICE EXHIBITED A FAULT CODE WHICH INDICATED THE INTERNAL BATTERY WAS CURRENTLY EXHIBITING A VOLTAGE TOO LOW TO SUPPORT THE PROJECTED REMAINING CAPACITY. NO RESULTING ADVERSE PATIENT EFFECTS. BOSTON SCIENTIFIC'S ENGINEERS REVIEWED DEVICE HISTORY, CONFIRMING THE DEVICE IS MALFUNCTIONING AND SHOULD BE REPLACED TO ENSURE NO LAPSE IN CRITICAL THERAPY. SUBSEQUENTLY, THE DEVICE WAS EXPLANTED AND RETURNED FOR A POST MARKET ASSESSMENT.

Description of Event or Problem · 1

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Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
313391 TELIGEN IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS GUIDANT CRM CLONMEL IRELAND F102

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| L| R