FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 3213699 · Received July 9, 2013

Report

Report Number
2124215-2013-08846
Event Type
Injury
Date Received
July 9, 2013
Date of Event
May 22, 2013
Report Date
May 22, 2013
Manufacturer
CPI - DEL CARIBE
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 THE PATIENT WITH THIS RIGHT ATRIAL (RA) LEAD WAS UNDERGOING A REPLACEMENT PROCEDURE. IT WAS REPORTED THAT THIS LEAD EXHIBITED HIGH OUT OF RANGE PACING IMPEDANCES GREATER THAN 2,500 OHMS AND WAS FRACTURED. THE LEAD WAS BEING REPLACED WITH A COMPETITOR'S PRODUCT. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
314448 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4470

Patients

Seq Age Sex Outcome Treatment
1 51 YR Hospitalization| L| R 4457| S606| 1290| 4470