FDA Adverse Event Malfunction Summary report: N

ISOFLEX S

MDR report key: 4140657 · Received January 13, 2014

Report

Report Number
2017865-2014-05781
Event Type
Malfunction
Date Received
January 13, 2014
Date of Event
October 11, 2012
Manufacturer
ST. JUDE MEDICAL, CARDIAC RHYTHM MANAGEMENT DIVISI
Product Code
NVN
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IT
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.

Description of Event or Problem · 1

IT WAS REPORTED THAT LEAD WAS UNDERSENSING. THE DEVICE WAS REPROGRAMMED FROM DDD TO VVI.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
33942 ISOFLEX S NVN ST. JUDE MEDICAL, CARDIAC RHYTHM MANAGEMENT DIVISI 1624T/52

Patients

Seq Age Sex Outcome Treatment
1