FDA Adverse Event Malfunction Summary report: N

PROGRAMMING SOFTWARE

MDR report key: 3813070 · Received May 15, 2014

Report

Report Number
1644487-2014-01269
Event Type
Malfunction
Date Received
May 15, 2014
Date of Event
March 30, 2014
Report Date
April 14, 2014
Manufacturer
CYBERONICS
Product Code
LYJ
PMA / PMN Number
P970003
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BE
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

REVIEW OF THE AVAILABLE PROGRAMMING AND DIAGNOSTIC HISTORY.

Description of Event or Problem · 1

DURING REVIEW OF PROGRAMMING AND DIAGNOSTIC HISTORY, IT WAS OBSERVED THAT AN INTERRUPTED GENERATOR DIAGNOSTIC TEST OCCURRED THAT CAUSED AN UNINTENDED CHANGE IN DEVICE SETTINGS DURING AN OFFICE VISIT ON (B)(6) 2014. THE PHYSICIAN CORRECTED THE SETTINGS; HOWEVER, THE MAGNET OUTPUT CURRENT AND MAGNET ON-TIME WERE NOT CORRECTED. NO PATIENT ADVERSE EVENTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
291249 PROGRAMMING SOFTWARE PROGRAMMING SOFTWARE LYJ CYBERONICS MODEL 250 1063524

Patients

Seq Age Sex Outcome Treatment
1 58 YR