FDA Adverse Event Injury Summary report: N

ZEPHYR DR

MDR report key: 3925690 · Received July 10, 2014

Report

Report Number
2017865-2014-15605
Event Type
Injury
Date Received
July 10, 2014
Date of Event
April 7, 2014
Manufacturer
ST. JUDE MEDICAL, INC., CRMD
Product Code
LWP
PMA / PMN Number
NA
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED.FINAL ANALYSIS FOUND THAT THE PULSE GENERATOR EXHIBITED PREMATURE BATTERY DEPLETION DUE TO A HIGH CURRENT DRAIN.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A FOLLOW-UP, THE PULSE GENERATOR EXHIBITED PREMATURE BATTERY DEPLETION AND A LEAD IMPEDANCE MEASUREMENT ANOMALY. THE DEVICE WAS EXPLANTED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
404857 ZEPHYR DR IMPLANTABLE PACEMAKER PULSE GENERATOR LWP ST. JUDE MEDICAL, INC., CRMD 5820 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention