FDA Adverse Event Injury Summary report: N

THINLINE

MDR report key: 3921776 · Received July 9, 2014

Report

Report Number
2124215-2014-11389
Event Type
Injury
Date Received
July 9, 2014
Date of Event
May 14, 2014
Report Date
May 14, 2014
Manufacturer
GUIDANT ANGLETON/ST. PAUL
Product Code
NVN
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

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 PRODUCT WAS PART OF A SYSTEM REVISION DUE TO INFECTION WITH ENDOCARDITIS. THERE WERE NO ADDITIONAL ADVERSE EFFECTS REPORTED. THE PRODUCT WAS EXPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
400371 THINLINE IMPLANTABLE LEAD NVN GUIDANT ANGLETON/ST. PAUL 438-10-58

Patients

Seq Age Sex Outcome Treatment
1 51 YR Hospitalization| L| R (B)(4)| (B)(4)| 1294| 1276