FDA Adverse Event Injury Summary report: N

CURRENT PLUS DR, DF-4 CONNECTOR

MDR report key: 3890314 · Received January 13, 2014

Report

Report Number
2938836-2014-03708
Event Type
Injury
Date Received
January 13, 2014
Date of Event
July 13, 2011
Manufacturer
ST. JUDE MEDICAL INC., CRMD
Product Code
LWS
PMA / PMN Number
P910023
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS HISTORICAL COMPLAINT IS BEING FILED AS PART OF A RETROSPECTIVE REVIEW OF COMPLAINT FILES IN RESPONSE TO A RECENT FDA INSPECTION. THERE IS NO CHANGE TO THE ACTUAL PERFORMANCE OF THE PRODUCT AND THIS REPORT ONLY REPRESENTS AN ENHANCEMENT TO THE REPORTING CRITERIA GOING FORWARD. COMPANY REP.

Description of Event or Problem · 1

IT WAS REPORTED THAT INAPPROPRIATE THERAPY DELIVERED TO THE PT. IT WAS RESOLVED BY ADJUST SVT DETECT CRITERIA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
30421 CURRENT PLUS DR, DF-4 CONNECTOR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS ST. JUDE MEDICAL INC., CRMD CD2211-36Q

Patients

Seq Age Sex Outcome Treatment
1 82 YR Required Intervention