BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TRANSVENE RV

    MDR report key: 3992718 · Received August 8, 2014

    Report

    Report Number
    2182208-2014-02366
    Event Type
    Injury
    Date Received
    August 8, 2014
    Date of Event
    January 1, 2003
    Report Date
    June 11, 2014
    Manufacturer
    MEDTRONIC, INC.
    Product Code
    LWS
    PMA / PMN Number
    P920015
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    VA, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    THIS INFORMATION IS BASED ENTIRELY ON JOURNAL LITERATURE AND FOLLOW UP OBTAINED FROM CORRESPONDENCE WITH THE AUTHORS. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. PATIENT INFORMATION IS LIMITED DUE TO CONFIDENTIALITY CONCERNS. REFERENCED ARTICLE: ¿DETECTION AND MANAGEMENT OF AN IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LEAD FAILURE¿ JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY. VOL. 41, NO.1. 2003; 73-80. (B)(4).

    Description of Event or Problem · 1

    A JOURNAL ARTICLE WAS REVIEWED WHICH CONTAINED INFORMATION REGARDING THIS LEAD. THROUGH FOLLOW UP WITH THE AUTHOR IT WAS DISCOVERED THAT THE LEAD SHOWED AN INSULATION BREACH. THE LEAD WAS INACTIVATED AND REPLACED. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    471322 TRANSVENE RV DEFIBRILLATOR, AUTOMATIC IMPLANTABLE CARDIOVERTER LWS MEDTRONIC, INC. 6936

    Patients

    Seq Age Sex Outcome Treatment
    1 00068 YR Hospitalization| R