FDA Adverse Event Malfunction Summary report: N

REVEAL LINQ

MDR report key: 3992894 · Received August 8, 2014

Report

Report Number
9614453-2014-01945
Event Type
Malfunction
Date Received
August 8, 2014
Date of Event
June 5, 2014
Report Date
June 24, 2014
Manufacturer
IPG MFG SWITZERLAND
Product Code
DSI
PMA / PMN Number
K132649
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
NURSE

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. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT ONE DAY AFTER IMPLANT OF THE IMPLANTABLE CARDIAC MONITOR, FALSE ASYSTOLE EPISODES WERE OBSERVED ON THE ELECTROGRAM BECAUSE OF UNDERSENSING DUE TO ELECTRODE DISCONNECT. THE DEVICE IS STILL 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
468038 REVEAL LINQ DETECTOR AND ALARM, ARRHYTHMIA DSI IPG MFG SWITZERLAND LNQ11

Patients

Seq Age Sex Outcome Treatment
1 00088 YR