FDA Adverse Event Injury Summary report: N

THINLINE EZ

MDR report key: 747148 · Received August 9, 2006

Report

Report Number
2124215-2006-99470
Event Type
Injury
Date Received
August 9, 2006
Date of Event
June 16, 2006
Manufacturer
ITM
Product Code
DTB
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WV, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

NOT RETURNED. EVENT CONCLUSION A NEW LEAD WAS SUCCESSFULLY IMPLANTED. THE LEAD WILL NOT BE RETURNED FOR ANALYSIS, THEREFORE, GUIDANT CANNOT CONFIRM THE CLINICAL OBSERVATION. LEAD DAMAGE IS NORMALLY A RESULT OF LEAD ON LEAD CONTACT OR LEAD ROUTING THROUGH THE BODY. IF ADDITIONAL INFORMATION IS OBTAINED, THIS EVENT WILL BE REOPENED.

Description of Event or Problem · 1

EVENT DESCRIPTION GUIDANT RECEIVED INFORMATION THAT THIS RIGHT VENTRICULAR (RV) LEAD FRACTURED, CAUSING RESISTANCE UP TO 2500 OHMS. THIS LEAD WAS ABANDONED SURGICALLY, AND A NEW RV LEAD WAS IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 THINLINE EZ IMPLANTABLE LEAD DTB ITM 438-10 *

Patients

Seq Age Sex Outcome Treatment
1 86 YR Required Intervention 1280| 430-10| 4456