FDA Adverse Event Malfunction Summary report: N

MICRA

MDR report key: 6160327 · Received December 9, 2016

Report

Report Number
9612164-2016-01246
Event Type
Malfunction
Date Received
December 9, 2016
Date of Event
October 14, 2016
Report Date
October 14, 2016
Manufacturer
MEDTRONIC IRELAND
Product Code
PNJ
PMA / PMN Number
P150033
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
HK
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

PRODUCT EVENT SUMMARY: THE DEVICE WAS RETURNED AND ANALYZED. ANALYSIS WAS PERFORMED AND NO ANOMALIES WERE FOUND.

Additional Manufacturer Narrative · 1

A GOOD FAITH EFFORT WILL BE MADE TO OBTAIN THE APPLICABLE INFORMATION RELEVANT TO THE REPORT. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING THE IMPLANT PROCEDURE THE PHYSICIAN REPOSITIONED THE LEADLESS IMPLANTABLE PULSE GENERATOR (IPG) SEVEN TIMES DUE TO LOW SENSING VALUES AND HIGH THRESHOLDS. THE IPG WAS DEPLOYED THE EIGHT TIME AND VALUES WERE ACCEPTABLE. THE TETHER WAS CUT AND REMOVED. AFTER REMOVAL OF TETHER, ELECTRICAL TEST WAS PERFORMED AGAIN, THE R WAVE WAS DECREASED AND PACING THRESHOLD WAS HIGH. X-RAY IMAGES SHOWED NO SIGNIFICANT DISLODGEMENT OR DISPLACEMENT OF THE DEVICE. THE PHYSICIANS DECIDED TO RETRIEVE THE DEVICE BY SNARING. THERE WAS NO BLOOD CLOT OR TISSUES ON THE SURFACE OF THE RETRIEVED DEVICE. THE PATIENT WILL RECEIVE AN IPG IN THE FUTURE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
807867 MICRA LEADLESS PACEMAKER PNJ MEDTRONIC IRELAND MC1VR01

Patients

Seq Age Sex Outcome Treatment
1 86 YR