FDA Adverse Event
Injury
Summary report: N
UNIFY CRT-D
MDR report key: 6210585
·
Received December 28, 2016
Report
- Report Number
- 2938836-2016-23346
- Event Type
- Injury
- Date Received
- December 28, 2016
- Date of Event
- December 2, 2016
- Report Date
- December 2, 2016
- Manufacturer
- ST. JUDE MEDICAL, INC.
- Product Code
- NIK
- PMA / PMN Number
- P030054
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IT
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
PLEASE RETRACT THIS MDR-2016-41678-01. THE COMPLAINT WAS REPORTED AND FILED ON (B)(6) 2016 2938836-2016-17825.
Additional Manufacturer Narrative · 1
PLEASE RETRACT THIS MDR 2938836-2016-23346. THE COMPLAINT WAS REPORTED AND FILED ON (B)(6) 2016, 2938836-2016-17825.
Additional Manufacturer Narrative · 1
(B)(4). BASED ON THE INFORMATION RECEIVED, THE DEVICE WAS PROPHYLACTICALLY REMOVED AND THERE IS NO ALLEGED MALFUNCTION OF THE PRODUCT. SHOULD THE DEVICE BE RETURNED AND THE ANALYSIS RESULTS INDICATE AN ANOMALY A FOLLOW UP REPORT WILL BE SUBMITTED.
Description of Event or Problem · 1
FOLLOWING THE ADVISORY FOR PREMATURE BATTERY DEPLETION WITH IMPLANTABLE CARDIOVERTER DEFIBRILLATOR, ALTHOUGH THERE WAS NO ERI ALERT OR ALLEGATION OF PREMATURE BATTERY DEPLETION, THE DEVICE WAS EXPLANTED PROPHYLACTICALLY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 859593 | UNIFY CRT-D | IMPLANTABLE CARDIOVERTER DEFIBRILLATOR | NIK | ST. JUDE MEDICAL, INC. | CD3235-40Q | 3498285 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Required Intervention |