FDA Adverse Event
Malfunction
Summary report: N
CONFIRM
MDR report key: 4121589
·
Received January 13, 2014
Report
- Report Number
- 2017865-2014-07691
- Event Type
- Malfunction
- Date Received
- January 13, 2014
- Date of Event
- October 20, 2011
- Manufacturer
- ST. JUDE MEDICAL, INC. CRMD
- Product Code
- MXC
- PMA / PMN Number
- K081365
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED. 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 DEVICE WAS UNABLE TO BE INTERROGATED AFTER TRYING TO ACCESS THE SEGMS. THE DEVICE DISPLAYED THE MESSAGE, ERROR - ABNORMAL EXIT DETECTED. CONFIRM SOFTWARE WAS RELOADED. AFTER DOWNLOAD, THE DEVICE WORKED APPROPRIATELY. DEVICE TO STAY IN THE FIELD.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 32231 | CONFIRM | IMPLANTABLE CARDIAC MONITOR | MXC | ST. JUDE MEDICAL, INC. CRMD | DM2100 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 53 YR |