FDA Adverse Event Malfunction Summary report: N

VITALITY AVT

MDR report key: 710965 · Received May 9, 2006

Report

Report Number
2124215-2006-13358
Event Type
Malfunction
Date Received
May 9, 2006
Date of Event
January 25, 2006
Report Date
January 25, 2006
Manufacturer
CARDIAC PACEMAKERS, INC
Product Code
LWS
Removal / Correction Number
NA
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 THIS IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (ICD) DECLARED END OF LIFE (EOL), EXHIBITING A MONITORING VOLTAGE OF 2.65V AND A CHARGE TIME OF 31 SEC. A CAPACITOR REFORM WAS PERFORMED, AND THE CHARGE TIME DROPPED TO 30.4 SECONDS. THIS DEVICE HAD BEEN IN SERVICE FOR 2.5 YEARS. A GUIDANT TECHNICAL SERVICES (TS) CONSULTANT RECOMMENDED EXPLANTING AND RETURNING THE DEVICE TO GUIDANT FOR ANALYSIS. TO DATE, THERE HAVE BEEN NO REPORTED PATIENT SYMPTOMS ASSOCIATED WITH THIS CLINICAL OBSERVATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VITALITY AVT IMPLANTABLE ATRIAL GENERATOR LWS CARDIAC PACEMAKERS, INC A135 NA

Patients

Seq Age Sex Outcome Treatment
1 79 YR Other