FDA Adverse Event Malfunction Summary report: N

SELOX ST 60

MDR report key: 3232151 · Received July 17, 2013

Report

Report Number
1028232-2013-01927
Event Type
Malfunction
Date Received
July 17, 2013
Date of Event
April 19, 2013
Report Date
July 4, 2013
Manufacturer
BIOTRONIK SE & CO. KG
Product Code
NVN
PMA / PMN Number
P950037
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE LEAD UNDER COMPLAINT WAS NOT RETURNED FOR ANALYSIS. THE ANALYSIS IS THEREFORE BASED ON THE INSPECTION OF THE QUALITY DOCUMENTS ASSOCIATED WITH THE MANUFACTURE OF THIS PARTICULAR LEAD AS WELL AS THE DEVICE DATA RETURNED FOR ANALYSIS. THE MANUFACTURING PROCESS FOR THIS LEAD WAS RE-INVESTIGATED. ALL PRODUCTION STEPS HAD BEEN PERFORMED ACCORDINGLY. THERE WAS NO SIGN OF ANY INCONSISTENCY DURING THE MANUFACTURING PROCESS WHICH MIGHT BE RELATED TO THE CLINICAL OBSERVATION. THE RETURNED DATA WERE ANALYZED. THE INSPECTION REVEALED A GRADUAL INCREASE OF THE PACING IMPEDANCE WITH VALUES UP TO > 3000 OHM AND THRESHOLD VALUES OF 4.2 V, CONFIRMING THE CLINICAL OBSERVATION. IN SUMMARY, THE LEAD WAS NOT RETURNED FOR ANALYSIS. BASED ON THE INFORMATION AVAILABLE FOR ANALYSIS, NO CONCLUSION CAN BE DRAWN REGARDING THE ROOT CAUSE OF THE CLINICAL OBSERVATION. THE REVIEW OF THE QUALITY DOCUMENTS CONFIRMED A REGULAR LEAD MANUFACTURING.

Description of Event or Problem · 1

OUS MDR - AFTER AN IMPLANT DURATION OF ABOUT 4.5 YEARS A GRADUAL INCREASE OF THE IMPEDANCE (>3000 OHMS) WAS REPORTED. THE LEAD WAS NOT RETURNED. NO ADVERSE PATIENT SIDE EFFECTS HAVE BEEN REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
330781 SELOX ST 60 PACER LEAD NVN BIOTRONIK SE & CO. KG 346367

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization