FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 3912269 · Received July 3, 2014

Report

Report Number
2124215-2014-11274
Event Type
Injury
Date Received
July 3, 2014
Date of Event
May 12, 2014
Report Date
May 12, 2014
Manufacturer
CPI - DEL CARIBE
Product Code
DTB
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). AS NO FURTHER INFORMATION CONCERNING THIS REPORT IS EXPECTED, OUR INVESTIGATION IS COMPLETE. THIS INVESTIGATION WILL BE UPDATED SHOULD FURTHER INFORMATION BE PROVIDED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS RIGHT VENTRICULAR (RV) LEAD EXHIBITED UNDERSENSING AND HIGH PACING THRESHOLD JUST THREE DAYS AFTER IMPLANT. THE LEAD WAS REPOSITIONED. ADDITIONAL INFORMATION RECEIVED INDICATED THAT THE ABOVE FINDINGS WERE DUE TO MICRODISLODGEMENT. THIS RV LEAD REMAINS IN SERVICE. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
391663 FINELINE II IMPLANTABLE LEAD DTB CPI - DEL CARIBE 4473

Patients

Seq Age Sex Outcome Treatment
1 77 YR Hospitalization| L| R K064| 4473| 4472