FDA Adverse Event Malfunction Summary report: N

ATTAIN ABILITY STRAIGHT

MDR report key: 3991379 · Received August 8, 2014

Report

Report Number
2649622-2014-08156
Event Type
Malfunction
Date Received
August 8, 2014
Date of Event
May 15, 2014
Report Date
May 16, 2014
Manufacturer
MPRI
Product Code
OJX
PMA / PMN Number
P080006
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

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 THE REMOTE TRANSMISSION SHOWED THERE WAS HIGH IMPEDANCE ON THE LEFT VENTRICULAR (LV) LEAD. THE LEAD 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
469848 ATTAIN ABILITY STRAIGHT DRUG ELUTING PERMANENT LEFT VENTRICULAR (LV) PACEMAKER ELECTRODE OJX MPRI 439688

Patients

Seq Age Sex Outcome Treatment
1 00070 YR