FDA Adverse Event Death Summary report: N

REVEAL PLUS

MDR report key: 3620659 · Received February 10, 2014

Report

Report Number
3004209178-2014-02723
Event Type
Death
Date Received
February 10, 2014
Date of Event
October 4, 2013
Report Date
January 16, 2014
Manufacturer
MEDTRONIC MED REL MEDTRONIC PUERTO RICO
Product Code
MXC
PMA / PMN Number
K994331
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS INFORMATION IS BASED ENTIRELY ON JOURNAL LITERATURE. THIS EVENT OCCURRED OUTSIDE THE US. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. THERE IS NO INFORMATION GIVEN AS TO THE EXACT DATE OF DEATH FOR THE PATIENT; THEREFORE, THE DATE OF DEATH INCLUDED IN THIS REPORT IS PURELY AN ESTIMATE. PATIENT INFORMATION IS LIMITED DUE TO CONFIDENTIALITY CONCERNS. REFERENCED ARTICLE: IMPLANTABLE LOOP RECORDER ALLOWS AN ETIOLOGIC DIAGNOSIS IN ONE-THIRD OF PATIENTS - RESULTS OF THE SPANISH REVEAL REGISTRY. CIRC. J. 2013;77(10):2535-2541. (B)(4).

Description of Event or Problem · 1

A JOURNAL ARTICLE WAS REVIEWED WHICH CONTAINED INFORMATION REGARDING THIS IMPLANTABLE LOOP RECORDER (ILR). THE ARTICLE INCLUDED THE FOLLOWING FAILURE MODES: DEATHS, EROSION, INFECTION, AND DEVICE "MALFUNCTION." INFORMATION OBTAINED THROUGH FOLLOW UP INDICATED THAT THIS PATIENT HAD EXPIRED. THERE WAS NO CAUSE OF DEATH AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
88337 REVEAL PLUS RECORDER,EVENT,IMPLANTABLE CARDIAC,(WITHOUT ARRHYTHMIA DETECTION) MXC MEDTRONIC MED REL MEDTRONIC PUERTO RICO 9526

Patients

Seq Age Sex Outcome Treatment
1 Death