FDA Adverse Event Malfunction Summary report: N

ATTAIN ABILITY

MDR report key: 3990168 · Received August 7, 2014

Report

Report Number
2649622-2014-08776
Event Type
Malfunction
Date Received
August 7, 2014
Date of Event
May 9, 2014
Report Date
May 9, 2014
Manufacturer
MPRI
Product Code
OJX
PMA / PMN Number
P080006
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

PRODUCT EVENT SUMMARY: THE FULL LEAD WAS RETURNED, ANALYZED, AND NO ANOMALIES WERE FOUND.

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING THE IMPLANT PROCEDURE, THE PATIENT¿S ANATOMY WAS VERY TORTUOUS IN THE CS (CORONARY SINUS) AND THE LEAD WOULD NOT STAY IN PLACE. THE LEAD WAS REMOVED AND A DIFFERENT LEAD WITH A DIFFERENT CURVE TO HELP MAINTAIN STABILITY WAS IMPLANTED INSTEAD. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
463412 ATTAIN ABILITY DRUG ELUTING PERMANENT LEFT VENTRICULAR (LV) PACEMAKER ELECTRODE OJX MPRI 419688

Patients

Seq Age Sex Outcome Treatment
1 00067 YR