FDA Adverse Event Injury Summary report: N

ATTAIN ABILITY PLUS

MDR report key: 3990458 · Received August 8, 2014

Report

Report Number
2649622-2014-08636
Event Type
Injury
Date Received
August 8, 2014
Date of Event
June 4, 2014
Report Date
June 13, 2014
Manufacturer
MPRI
Product Code
OJX
PMA / PMN Number
P080006
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

PRODUCT EVENT SUMMARY: THE PROXIMAL SEGMENT OF THE LEAD WAS RETURNED AND ANALYZED. ANALYSIS WAS PERFORMED AND NO ANOMALIES WERE FOUND. VISUAL SUMMARY ANALYSIS OF THE LEAD INDICATED APPARENT EXPLANT DAMAGE.

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. CONCOMITANT MEDICAL PRODUCTS: 5076-45 LEAD, (B)(6) 2014; DTBB1D4 ICD, (B)(6) 2014. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THREE MONTHS AFTER IMPLANT, THE PATIENT DEVELOPED METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) BACTEREMIA, ENDOCARDITIS, AND VEGETATION ON THE RIGHT VENTRICULAR LEAD. THE IMPLANTABLE CARDIAC DEFIBRILLATOR (ICD) AND LEADS WERE EXPLANTED. NO FURTHER PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
467315 ATTAIN ABILITY PLUS DRUG ELUTING PERMANENT LEFT VENTRICULAR (LV) PACEMAKER ELECTRODE OJX MPRI 429688

Patients

Seq Age Sex Outcome Treatment
1 00056 YR Hospitalization| R 6947M55 LEAD