FDA Adverse Event Malfunction Summary report: N

PARADYM

MDR report key: 5362866 · Received January 13, 2016

Report

Report Number
1000165971-2016-00029
Event Type
Malfunction
Date Received
January 13, 2016
Date of Event
January 4, 2016
Report Date
January 7, 2016
Manufacturer
SORIN GROUP ITALIA S.R.L. - CRM FACILITY
Product Code
LWS
PMA / PMN Number
PP980049
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PO
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

DURING A STANDARD FOLLOW-UP ON (B)(6) 2016, 3 WARNING MESSAGES WERE DISPLAYED: "[3] LOW SHOCK IMPEDANCE. DEFIBRILLATION SYSTEM INEFFECTIVE"; "[48] MAX SHOCK ENERGY INEFFECTIVE ON (B)(6) 2016"; "[46] HIGH SHOCK IMPEDANCE DETECTED ON (B)(6) 2016: DEFIBRILLATION SYSTEM INEFFECTIVE." NINE SHOCKS WERE DELIVERED, ALL OF THEM WITH STORED ENERGY = 41.9J AND DELIVERED ENERGY = 0J. THE SHOCK LEAD INTEGRITY CURVE IS STABLE AND IN THE NORMAL RANGE. IN THE MEMORIES OF THE DEVICE, EGM EPISODES WITH ATRIAL UNDERSENSING WERE RECORDED. THE PHYSICIAN CHANGED ATRIAL SENSITIVITY FROM 0.4 MV TO 0.2MV. A NEW FOLLOW-UP WAS SCHEDULED ON (B)(6) 2016.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
23110 PARADYM DEFIBRILLATOR, IMPLANTABLE, DUAL-CHAMBER LWS SORIN GROUP ITALIA S.R.L. - CRM FACILITY PARADYM DR 8550 2408

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention