FDA Adverse Event Malfunction Summary report: N

SPRINT QUATTRO SECURE

MDR report key: 3993026 · Received August 8, 2014

Report

Report Number
2649622-2014-09522
Event Type
Malfunction
Date Received
August 8, 2014
Date of Event
December 8, 2013
Report Date
June 26, 2014
Manufacturer
MPRI
Product Code
NVY
PMA / PMN Number
P920015
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

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 THERE WAS AN INAPPROPRIATE DEVICE ALERT FOR EPISODES OF NONSUSTAINED VENTRICULAR TACHYCARDIA RESULTING IN REPROGRAMMING OF THE DEVICE BY PROLONGING THE NUMBER OF INTERVALS TO DETECT/REDETECT (NID). A COMPARISON OF THE USE BEFORE DATE FIELD AND IMPLANT DATE FOUND THE RIGHT VENTRICULAR (RV) LEAD WAS IMPLANTED AFTER THE USE BEFORE DATE. THE DEVICE AND RV LEAD REMAIN IN USE. THE PATIENT WAS REPORTED TO BE ENROLLED IN THE PANORAMA II CLINICAL STUDY. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
467829 SPRINT QUATTRO SECURE DRUG-ELUTING PERMANENT DEFIBRILLATOR ELECTRODES NVY MPRI 6947M55

Patients

Seq Age Sex Outcome Treatment
1 00066 YR DVBC3D4 ICD