FDA Adverse Event Malfunction Summary report: N

ISOFLEX P

MDR report key: 3926303 · Received July 10, 2014

Report

Report Number
2017865-2014-15602
Event Type
Malfunction
Date Received
July 10, 2014
Date of Event
May 28, 2014
Manufacturer
ST. JUDE MEDICAL, INC., CRMD
Product Code
NVN
PMA / PMN Number
NA
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE ATRIAL LEAD EXHIBITED UNDERSENSING. THE DEVICE WAS REPROGRAMMED AND THE LEAD REMAINED IMPLANTED. THE PATIENT WAS IN GOOD CONDITION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
405220 ISOFLEX P PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, INC., CRMD 1648T/58 NA

Patients

Seq Age Sex Outcome Treatment
1 80 YR