BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CURRENT PLUS DR

    MDR report key: 4091516 · Received January 13, 2014

    Report

    Report Number
    2938836-2014-04829
    Event Type
    Malfunction
    Date Received
    January 13, 2014
    Date of Event
    December 15, 2012
    Manufacturer
    ST. JUDE MEDICAL INC., CRMD
    Product Code
    LWS
    PMA / PMN Number
    P910023
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    ALL INFO PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS REC'D. THIS HISTORICAL COMPLAINT IS BEING FILED AS PART OF A RETROSPECTIVE REVIEW OF COMPLAINT FILES IN RESPONSE TO A RECENT FDA INSPECTION. THERE IS NO CHANGE TO THE ACTUAL PERFORMANCE OF THE PRODUCT AND THIS REPORT ONLY REPRESENTS AN ENHANCEMENT TO THE REPORTING CRITERIA GOING FORWARD.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE PATIENT PRESENTED IN THE HOSPITAL EMERGENCY ROOM WITH A DEVICE THAT HAD AN ALERT MESSAGE FOR OUTPUT CIRCUIT DAMAGE. A SHORTED OUTPUT STAGE DETECTION WAS NOTED. THE PATIENT WAS HAVING A BRAIN TUMOR REMOVED ON THE DATE OF THE SOSD. EXTERNAL NOISE WAS BEING OVERSENSED CAUSING FALSE VF TO BE DETECTED AND NO THERAPIES DELIVERED. THE DEVICE WAS REPROGRAMMED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    23255 CURRENT PLUS DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS ST. JUDE MEDICAL INC., CRMD CD2211-36

    Patients

    Seq Age Sex Outcome Treatment
    1 80 YR