FDA Adverse Event Malfunction Summary report: N

ISOFLEX OPTIM LEAD

MDR report key: 4192314 · Received January 11, 2014

Report

Report Number
2017865-2014-02141
Event Type
Malfunction
Date Received
January 11, 2014
Date of Event
May 25, 2012
Manufacturer
ST. JUDE MEDICAL, CARDIAC RHYTHM MANAGEMENT DIVISI
Product Code
DTB
PMA / PMN Number
P960030
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 THE DEVICE DETECTED NOISE ON THE ATRIAL CHANNEL. NOISE WAS REPRODUCED. NO CHANGES MADE TO THE DEVICE. THE PT CONDITION WAS GOOD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
22397 ISOFLEX OPTIM LEAD PERMANENT PACEMAKER ELECTRODE DTB ST. JUDE MEDICAL, CARDIAC RHYTHM MANAGEMENT DIVISI 1944/52

Patients

Seq Age Sex Outcome Treatment
1