FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 4220989 · Received November 3, 2014

Report

Report Number
2124215-2014-19344
Event Type
Injury
Date Received
November 3, 2014
Date of Event
August 25, 2014
Report Date
August 25, 2014
Manufacturer
CPI - DEL CARIBE
Product Code
DTB
PMA / PMN Number
P960004
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

(B)(4). AS NO FURTHER INFORMATION CONCERNING THIS REPORT IS EXPECTED, OUR INVESTIGATION IS COMPLETE. THIS INVESTIGATION WILL BE UPDATED SHOULD FURTHER INFORMATION BE PROVIDED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS PRODUCT WAS PART OF A SYSTEM REVISION DUE TO INFECTION AND EROSION. THERE WERE NO ADDITIONAL ADVERSE EFFECTS REPORTED. THE PRODUCT REMAINS IN SERVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
702587 FINELINE II IMPLANTABLE LEAD DTB CPI - DEL CARIBE 4456

Patients

Seq Age Sex Outcome Treatment
1 70 YR Hospitalization| L| R 4479| 4456| K173