FDA Adverse Event Injury Summary report: N

RELIA VDD

MDR report key: 3861280 · Received June 10, 2014

Report

Report Number
3008973940-2014-00223
Event Type
Injury
Date Received
June 10, 2014
Date of Event
March 8, 2014
Report Date
April 25, 2014
Manufacturer
MEDTRONIC SINGAPORE OPERATIONS
Product Code
NVZ
PMA / PMN Number
P980035
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PRODUCT EVENT SUMMARY: THE DEVICE WAS RETURNED AND ANALYZED. ANALYSIS REVEALED THE RETURNED DEVICE INDICATED NORMAL BATTERY DEPLETION.

Additional Manufacturer Narrative · 1

THIS EVENT OCCURRED OUTSIDE THE US WHERE THE SAME MODEL IS DISTRIBUTED. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. PATIENT INFORMATION IS NOT GENERALLY AVAILABLE DUE TO CONFIDENTIALITY CONCERNS. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE HAD POTENTIAL EARLY BATTERY DEPLETION. THE DEVICE WAS EXPLANTED AND REPLACED. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
339844 RELIA VDD PULSE GENERATOR, PERMANENT, IMPLANTABLE NVZ MEDTRONIC SINGAPORE OPERATIONS REVDD01

Patients

Seq Age Sex Outcome Treatment
1 00062 YR Hospitalization| R