FDA Adverse Event Injury Summary report: N

ATTAIN ABILITY PLUS

MDR report key: 4162457 · Received October 10, 2014

Report

Report Number
2649622-2014-12765
Event Type
Injury
Date Received
October 10, 2014
Date of Event
August 5, 2014
Report Date
August 5, 2014
Manufacturer
MPRI
Product Code
OJX
PMA / PMN Number
P080006
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. CONCOMITANT MEDICAL PRODUCTS: A 5076-52 LEAD, IMPLANTED: (B)(6) 2012. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THERE WAS CHRONIC HIGH THRESHOLD. THE LEAD WAS EXPLANTED AND REPLACED. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
639704 ATTAIN ABILITY PLUS DRUG ELUTING PERMANENT LEFT VENTRICULAR (LV) PACEMAKER ELECTRODE OJX MPRI 429678

Patients

Seq Age Sex Outcome Treatment
1 00032 YR Hospitalization| R S606 COMPETITOR IPG