FDA Adverse Event Injury Summary report: N

ATTAIN ABILITY PLUS

MDR report key: 3861371 · Received June 10, 2014

Report

Report Number
2649622-2014-07291
Event Type
Injury
Date Received
June 10, 2014
Date of Event
April 22, 2014
Report Date
April 22, 2014
Manufacturer
MPRI
Product Code
OJX
PMA / PMN Number
P080006
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. CONCOMITANT PRODUCTS: 4592-45, LEAD, IMPLANTED: (B)(6) 2004; 6944-58, LEAD, IMPLANTED: (B)(6) 2004. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT HAD A SEPSIS INFECTION AFTER A GENERATOR UPGRADE PROCEDURE. THE IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (ICD) SYSTEM WAS REMOVED. NO FURTHER PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
338762 ATTAIN ABILITY PLUS DRUG ELUTING PERMANENT LEFT VENTRICULAR (LV) PACEMAKER ELECTRODE OJX MPRI 429688

Patients

Seq Age Sex Outcome Treatment
1 00059 YR Hospitalization| L| R DTBA1D1 CRT-D