FDA Adverse Event Death Summary report: N

INTERVENE LEAD

MDR report key: 383408 · Received February 8, 2002

Report

Report Number
2124215-2002-03688
Event Type
Death
Date Received
February 8, 2002
Date of Event
October 5, 2001
Report Date
October 11, 2001
Manufacturer
CARDIAC PACEMAKERS
Product Code
LWS
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

EVENT DESCRIPTION GUIDANT RECEIVED INFORMATION THAT THE PATIENT WAS HOSPITALIZED FOR PNEUMONIA, DURING WHICH, HE SUFFERED A CARDIAC ARREST. THE PATIENT LATER GOES INTO EMD AND DIES. THE PHYSICIAN SUSPECTS THAT THE ICD DETECTED THE PATIENT'S VF BUT DID NOT ADEQUATELY TREAT IT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INTERVENE LEAD IMPLANTABLE LEAD LWS CARDIAC PACEMAKERS 497-19 NA

Patients

Seq Age Sex Outcome Treatment
1 65 YR Death THE DEVICE 438-/08688M WAS IMPLANTED 06-AUG-1998| THE DEVICE 101-/01523 WAS IMPLANTED 06-AUG-1998