FDA Adverse Event Malfunction Summary report: N

CONFIRM

MDR report key: 4140191 · Received January 13, 2014

Report

Report Number
2017865-2014-05956
Event Type
Malfunction
Date Received
January 13, 2014
Date of Event
September 15, 2011
Manufacturer
ST. JUDE MEDICAL, CARDIAC RHYTHM MANAGEMENT DIVISI
Product Code
MXC
PMA / PMN Number
K081365
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ALL INFO PROVIDED BY MFR, 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 AN ERROR MESSAGE APPEARED WHEN INTERROGATING A DEVICE AND WOULD NOT ALLOW RETRIEVAL OF EPISODES. STORED ELECTROGRAMS WERE RECOVERED FROM A DEVICE IMAGE SENT TO TECHNICAL SERVICES AND THE ERROR WAS CLEARED AFTER UPDATED DEVICE CODE WAS RELOADED. THE DEVICE REMAINED IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
34263 CONFIRM IMPLANTABLE CARDIAC MONITOR MXC ST. JUDE MEDICAL, CARDIAC RHYTHM MANAGEMENT DIVISI DM2100

Patients

Seq Age Sex Outcome Treatment
1