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