BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ALTRUA

    MDR report key: 4132209 · Received October 1, 2014

    Report

    Report Number
    2124215-2014-16632
    Event Type
    Malfunction
    Date Received
    October 1, 2014
    Date of Event
    May 30, 2014
    Report Date
    July 22, 2014
    Manufacturer
    GUIDANT CRM CLONMEL IRELAND
    Product Code
    LWP
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). AS NO FURTHER INFORMATION CONCERNING THIS REPORT IS EXPECTED, OUR INVESTIGATION IS COMPLETE. THIS INVESTIGATION WILL BE UPDATED SHOULD FURTHER INFORMATION BE PROVIDED.

    Description of Event or Problem · 1

    BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS PACEMAKER EXHIBITED ATRIAL PACE - VENTRICULAR PACE AT 120 BEATS PER MINUTE (BPM). IT WAS REPORTED MINUTE VENTILATION (MV) WAS PROGRAMMED ON AT THE TIME OF THE OBSERVATION. TECHNICAL SERVICES DISCUSSED INTEGRATION BETWEEN HOSPITAL EQUIPMENT AND MV. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    612554 ALTRUA IMPLANTABLE PULSE GENERATOR LWP GUIDANT CRM CLONMEL IRELAND S603

    Patients

    Seq Age Sex Outcome Treatment
    1 89 YR S603| 4470| 4469