FDA Adverse Event Malfunction Summary report: N

QUICKFLEX MICRO LV LEAD

MDR report key: 4121216 · Received January 13, 2014

Report

Report Number
2017865-2014-07083
Event Type
Malfunction
Date Received
January 13, 2014
Date of Event
December 19, 2011
Manufacturer
ST. JUDE MEDICAL, INC. CRMD
Product Code
NIK
PMA / PMN Number
P030054
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

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. ANALYSIS WAS NORMAL. NO ANOMALIES WERE FOUND.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE LEAD WAS UNABLE TO BE IMPLANTED DUE TO NOT GETTING OPTIMUM MEASUREMENTS. THE LEAD WAS NOT USED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
32584 QUICKFLEX MICRO LV LEAD PERMANENT PACEMAKER ELECTRODE, NIK NIK ST. JUDE MEDICAL, INC. CRMD 1258T/86

Patients

Seq Age Sex Outcome Treatment
1