FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 3223535 · Received July 12, 2013

Report

Report Number
2124215-2013-10595
Event Type
Injury
Date Received
July 12, 2013
Date of Event
January 9, 2006
Report Date
June 5, 2013
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
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 HAD A CONDUCTOR FRACTURE RESULTING TO DYSPNEA AND HEART FAILURE. THIS LEAD WAS SURGICALLY ABANDONED AND SUCCESSFULLY REPLACED. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
322197 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4473

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| L| R