FDA Adverse Event Malfunction Summary report: N

ACCENT DR RF PACEMAKER

MDR report key: 7001795 · Received November 3, 2017

Report

Report Number
2938836-2017-33598
Event Type
Malfunction
Date Received
November 3, 2017
Date of Event
October 23, 2017
Report Date
November 3, 2017
Manufacturer
ST. JUDE MEDICAL, INC.(CRM-SUNNYVALE)
Product Code
LWP
PMA / PMN Number
P030035
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT PRESENTED FOR A ROUTINE FOLLOW-UP. A CYBER SECURITY UPDATE WAS ATTEMPTED AND THE DEVICE ENTERED BVVI. AN FSM STATE ACTION ERROR MESSAGED DISPLAYED UPON INTERROGATION. THE DEVICE WAS RESTORED AND THE FIRMWARE WAS UPGRADED. THE PATIENT WAS ASYMPTOMATIC. DEVICE REMAINS IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
778496 ACCENT DR RF PACEMAKER IMPLANTABLE PACEMAKER PULSE GENERATOR LWP ST. JUDE MEDICAL, INC.(CRM-SUNNYVALE) PM2210 3325965

Patients

Seq Age Sex Outcome Treatment
1 84 YR