FDA Adverse Event Injury Summary report: N

REVEAL LINQ

MDR report key: 3991206 · Received August 8, 2014

Report

Report Number
9614453-2014-01722
Event Type
Injury
Date Received
August 8, 2014
Date of Event
May 9, 2014
Report Date
June 11, 2014
Manufacturer
IPG MFG SWITZERLAND
Product Code
DSI
PMA / PMN Number
K132649
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. THIS EVENT OCCURRED OUTSIDE THE US WHERE THE SAME MODEL IS DISTRIBUTED. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. PATIENT INFORMATION IS NOT GENERALLY AVAILABLE DUE TO CONFIDENTIALITY CONCERNS. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT WITHIN APPROXIMATELY ONE MONTH OF IMPLANT, THERE WAS UNDERSENSING AND INCORRECT AT (ATRIAL TACHYCARDIA) SENSING. THE DEVICE WAS REPROGRAMMED AND REMAINS IN USE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
467766 REVEAL LINQ DETECTOR AND ALARM, ARRHYTHMIA DSI IPG MFG SWITZERLAND LNQ11

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention