FDA Adverse Event Injury Summary report: N

VITALITY 2

MDR report key: 3913544 · Received July 3, 2014

Report

Report Number
2124215-2014-09216
Event Type
Injury
Date Received
July 3, 2014
Date of Event
April 11, 2014
Report Date
April 30, 2014
Manufacturer
GUIDANT CRM CLONMEL IRELAND
Product Code
LWS
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE PRODUCT IS EXPECTED TO BE RETURNED FOR ANALYSIS. THIS REPORT WILL BE UPDATED UPON RETURN AND COMPLETION OF ANALYSIS.

Additional Manufacturer Narrative · 1

(B)(4). UPON RECEIPT AT OUR POST MARKET QUALITY ASSURANCE LABORATORY, A REVIEW OF DEVICE MEMORY REVEALED THAT THE DEVICE DECLARED END OF LIFE (EOL) AFTER EXPERIENCING ONE CHARGE TIME GREATER THAN 30 SECONDS. THE OBSERVED RATE OF BATTERY USAGE WAS COMPARED TO THE EXPECTED RATE OF BATTERY USAGE; THE RESULTS INDICATED THAT THE MONITORING VOLTAGE WAS NORMAL. ALTHOUGH THE BATTERY ITSELF HAD NOT DEPLETED PREMATURELY, EOL WAS TRIGGERED EARLIER THAN EXPECTED BY EXTENDED CHARGE TIMES DUE TO A HIGHER-THAN-TYPICAL BUILD-UP OF INTERNAL BATTERY IMPEDANCE.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (ICD) WAS SUSPECTED TO HAVE PREMATURE BATTERY DEPLETION (PBD). A SURGICAL INTERVENTION WAS DONE TO EXPLANT THIS DEVICE AND IMPLANT A NEW DEVICE. THIS DEVICE NO LONGER REMAINS IN SERVICE. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 1

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Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
391881 VITALITY 2 IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS GUIDANT CRM CLONMEL IRELAND T167

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| L| R