FDA Adverse Event Malfunction Summary report: N

FINELINE II

MDR report key: 3232716 · Received July 18, 2013

Report

Report Number
2124215-2013-11262
Event Type
Malfunction
Date Received
July 18, 2013
Date of Event
June 25, 2013
Report Date
June 25, 2013
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
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 PATIENT WITH AN IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (ICD) AND RIGHT ATRIAL (RA) LEAD HAD HIGH PACING IMPEDANCE AND THRESHOLD MEASUREMENTS WITH LOSS OF CAPTURE. THE LEAD DID NOT SENSE THE P WAVES AS WELL. NO DISLODGEMENT OR FRACTURE WAS NOTED ON FLUOROSCOPY. SINCE THE PATIENT HAD NORMAL SINUS RHYTHM, THE LEAD WAS DEACTIVATED AND THE DEVICE WAS REPROGRAMMED. NO ADVERSE PATIENT EFFECTS WERE REPORTED. THE DEVICE REMAINS IN SERVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
334721 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4480

Patients

Seq Age Sex Outcome Treatment
1