FDA Adverse Event Death Summary report: N

FINELINE II

MDR report key: 637752 · Received February 9, 2004

Report

Report Number
2124215-2004-06318
Event Type
Death
Date Received
February 9, 2004
Date of Event
October 1, 2003
Report Date
October 1, 2003
Manufacturer
CARDIAC PACEMAKERS, INC
Product Code
DTB
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
LAY USER/PATIENT

Narratives

Description of Event or Problem · 1

EVENT DESCRIPTION GUIDANT RECEIVED INFORMATION THAT DURING THE IMPLANT PROCEDURE, THE PHYSICIAN EXPERIENCE DIFFICULTY, AND USED FORCE, WHILE TRYING TO ADVANCE THE 4087 (200955) IMPLANTABLE LEAD THROUGH THE INTRODUCER. THE LEAD WAS EXPLANTED AND RETURNED FOR ANALYSIS. AFTER POCKET CLOSURE, THE PATIENT'S HEART STOPPED BEATING. AN ELECTROCARDIOGRAM (EKG) CONFIRMED PACING SPIKES, HOWEVER ATRIAL AND VENTRICULAR IMPLANTABLE LEAD CAPTURE WAS NOT DEMONSTRATED IN AAT, VVI OR VDD MODES AT MAXIMUM OUTPUTS. THE PATIENT WITH THIS PACING SYSTEM EXPIRED DURING THE IMPLANT PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FINELINE II IMPLANTABLE LEAD DTB CARDIAC PACEMAKERS, INC 4456 NA

Patients

Seq Age Sex Outcome Treatment
1 73 YR Death