FDA Adverse Event
Malfunction
Summary report: N
REVEAL LINQ
MDR report key: 4160955
·
Received October 10, 2014
Report
- Report Number
- 9614453-2014-02342
- Event Type
- Malfunction
- Date Received
- October 10, 2014
- Date of Event
- July 11, 2014
- Report Date
- July 11, 2014
- Manufacturer
- IPG MFG SWITZERLAND
- Product Code
- DSI
- PMA / PMN Number
- K132649
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- SZ
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
THIS EVENT OCCURRED OUTSIDE THE US WHERE THE SAME MODEL IS DISTRIBUTED. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. PATIENT INFORMATION IS NOT GENERALLY AVAILABLE DUE TO CONFIDENTIALITY CONCERNS. (B)(4).
Description of Event or Problem · 1
IT WAS REPORTED THAT THE IMPLANTABLE CARDIAC MONITOR RECORDED AN ASYSTOLE THAT THE PHYSICIAN QUESTIONED AS AN ARTIFACT/NOISE. IT WAS DETERMINED THAT THE ICM HAD ENCOUNTERED A LOSS OF CONTACT. THE POCKET SITE WAS MANIPULATED WITHOUT PROBLEM, AND THE DEVICE REMAINS IN USE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 642316 | REVEAL LINQ | DETECTOR AND ALARM, ARRHYTHMIA | DSI | IPG MFG SWITZERLAND | LNQ11 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 00046 YR | Hospitalization| R |