FDA Adverse Event Malfunction Summary report: N

REPLY

MDR report key: 6489257 · Received April 13, 2017

Report

Report Number
1000165971-2017-00308
Event Type
Malfunction
Date Received
April 13, 2017
Date of Event
March 8, 2017
Report Date
March 16, 2017
Manufacturer
SORIN GROUP ITALIA S.R.L. - CRM FACILITY
Product Code
NVZ
PMA / PMN Number
P950029
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A PLANNED FOLLOW-UP ON (B)(6) 2017, THE SUBJECT PACEMAKER WAS UNEXPECTEDLY FOUND TO BE OPERATING IN STANDBY MODE. THE PACEMAKER WAS RE-INITIALIZED AND THE NEXT FOLLOW-UP WAS SCHEDULED FOR (B)(6) 2017. PRELIMINARY ANALYSIS RESULTS CONFIRMED THE REPORTED SWITCH IN STANDBY MODE. IT WAS MOST PROBABLY DUE TO A SINGLE EVENT UPSET (SEU). THE DEVICE WAS PROPERLY RE-INITIALIZED DURING THE FOLLOW-UP PERFORMED ON (B)(6) 2017 AND ITS NORMAL FUNCTIONING WAS RESTORED.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A PLANNED FOLLOW-UP ON (B)(6) 2017, THE SUBJECT PACEMAKER WAS UNEXPECTEDLY FOUND TO BE OPERATING IN STANDBY MODE. THE PACEMAKER WAS RE-INITIALIZED AND THE NEXT FOLLOW-UP WAS SCHEDULED FOR (B)(6) 2017. PRELIMINARY ANALYSIS RESULTS CONFIRMED THE REPORTED SWITCH IN STANDBY MODE. IT WAS MOST PROBABLY DUE TO A SINGLE EVENT UPSET (SEU). THE DEVICE WAS PROPERLY RE-INITIALIZED DURING THE FOLLOW-UP PERFORMED ON (B)(6) 2017 AND ITS NORMAL FUNCTIONING WAS RESTORED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
271724 REPLY PULSE GENERATOR, PERMANENT, IMPLANTABLE NVZ SORIN GROUP ITALIA S.R.L. - CRM FACILITY REPLY DR 2511

Patients

Seq Age Sex Outcome Treatment
1