BEUDAMED
    FDA Adverse Event Injury Summary report: N

    QUADRA ASSURA DDQP+

    MDR report key: 6218275 · Received January 3, 2017

    Report

    Report Number
    2938836-2017-00080
    Event Type
    Injury
    Date Received
    January 3, 2017
    Date of Event
    December 16, 2016
    Report Date
    December 16, 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

    (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. (PZ PMK DEPENDANT).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    3045 QUADRA ASSURA DDQP+ IMPLANTABLE CARDIOVERTER DEFIBRILLATOR NIK ST. JUDE MEDICAL, INC. CD3267-40 3809659

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention