FDA Adverse Event Malfunction Summary report: N

PROGRAMMING SOFTWARE

MDR report key: 3895460 · Received June 25, 2014

Report

Report Number
1644487-2014-01598
Event Type
Malfunction
Date Received
June 25, 2014
Date of Event
November 10, 2010
Report Date
May 28, 2014
Manufacturer
CYBERONICS INC
Product Code
LYJ
PMA / PMN Number
P970003
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ANALYSIS OF PROGRAMMING HISTORY.

Description of Event or Problem · 1

DURING REVIEW OF THE IN-HOUSE PROGRAMMING/DIAGNOSTIC HISTORY DATABASE, IT WAS OBSERVED THAT ON OFFICE VISIT ON (B)(6) 2011 THE PATIENT'S SETTINGS WERE DIFFERENT THAN WHAT WERE PROGRAMMED AT THE PREVIOUS OFFICE VISIT ON (B)(6) 2010. THE SETTINGS FOUND WERE INDICATIVE OF A INTERRUPTED DIAGNOSTIC TEST; HOWEVER, REVIEW OF SYSTEM DIAGNOSTIC TESTING FROM OFFICE VISIT ON (B)(6) 2010 WAS WITHIN NORMAL LIMITS. THE DEVICE WAS NOT INTERROGATED PRIOR TO THE PATIENT LEAVING THE OFFICE ON (B)(6) 2010 AS RECOMMENDED BY DEVICE MANUFACTURER TO ENSURE THE DEVICE IS AT THE CORRECT SETTINGS; THEREFORE, THE SETTINGS WERE NOT CORRECTED PRIOR TO THE PATIENT LEAVING THE OFFICE. THE SETTINGS WERE CORRECTED ON (B)(6) 2011. NO PATIENT ADVERSE EVENTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
370334 PROGRAMMING SOFTWARE PROGRAMMING SOFTWARE LYJ CYBERONICS INC MODEL 250 678293

Patients

Seq Age Sex Outcome Treatment
1 18 YR