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 |