FDA Adverse Event Injury Summary report: N

PROMOTE RF CRT-D

MDR report key: 3791013 · Received May 5, 2014

Report

Report Number
2938836-2014-10516
Event Type
Injury
Date Received
May 5, 2014
Date of Event
February 27, 2014
Manufacturer
ST. JUDE MEDICAL, INC., CRMD
Product Code
NIK
PMA / PMN Number
NA
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

DEVICE EVALUATION ANTICIPATED, BUT NOT YET BEGUN.

Additional Manufacturer Narrative · 1

ANALYSIS DID NOT CONFIRM THE PREMATURE BATTERY DEPLETION. BASED ON DEVICE SETTINGS, A LONGEVITY CALCULATION WAS PERFORMED AND FOUND TO BE WITHIN EXPECTED LIMITS. THE PREMATURE BATTERY DEPLETION OBSERVED IN THE FIELD WAS A DISCREPANCY IN THE BATTERY LONGEVITY ESTIMATE DUE TO A DIAGNOSTIC ANOMALY. THE DEVICE WAS TESTED ON THE BENCH AS WELL AS USING AUTOMATED TEST EQUIPMENT, AND NO ANOMALIES WERE FOUND. THE CAUSE OF THE DIAGNOSTIC ANOMALY COULD NOT BE DETERMINED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE EXHIBITED PREMATURE BATTERY DEPLETION. THE DEVICE WAS EXPLANTED AND REPLACED. THERE WERE NO ADVERSE CONSEQUENCES TO THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
269095 PROMOTE RF CRT-D IMPLANTABLE CARDIOVERTER DEFIBRILLATOR NIK ST. JUDE MEDICAL, INC., CRMD 3213-36 NA

Patients

Seq Age Sex Outcome Treatment
1 81 YR Required Intervention