FDA Adverse Event
Malfunction
Summary report: N
CURRENT ACCEL DR
MDR report key: 3884738
·
Received June 19, 2014
Report
- Report Number
- 2938836-2014-12162
- Event Type
- Malfunction
- Date Received
- June 19, 2014
- Date of Event
- May 14, 2014
- Manufacturer
- ST. JUDE MEDICAL, INC., CRMD
- Product Code
- LWS
- PMA / PMN Number
- P910023
- Removal / Correction Number
- NA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- AU
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED.
Description of Event or Problem · 1
IT WAS REPORTED THAT INTERMITTENT ATRIAL UNDERSENSING WAS OBSERVED. PROGRAMMING CHANGES WERE MADE, HOWEVER, FURTHER REPROGRAMMING WAS RECOMMENDED. PATIENT WAS UNAWARE THERE WAS AN ISSUE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 360665 | CURRENT ACCEL DR | IMPLANTABLE CARDIOVERTER DEFIBRILLATOR | LWS | ST. JUDE MEDICAL, INC., CRMD | CD2215-36 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 84 YR |