MAUDE Adverse Event Report: BIOTRONIK SE & CO. KG COROX OTW-L 85-BP; LV LEAD

Model Number 368346

Device Problem Fracture (1260)

Patient Problems Undesired Nerve Stimulation (1980); Cardiac Perforation (2513); Device Embedded In Tissue or Plaque (3165)

Event Date 01/31/2023

Event Type  Injury  

Event Description

This lv lead was in the process of being explanted for a quadripolar lead in order to eliminate diaphragmatic stimulation when it fractured.During this, the patient started to bleed and part of the lead remained in the patient.The patient was taken to cardiac surgery for the bleed and there may have been a perforation.The surgery was successful.Should additional information be received, this file will be updated.

Manufacturer Narrative

The lead is currently not available for analysis.No conclusion can be drawn based on available information at the moment.The file is closed.The investigation will be re-opened should additional data become available.

• Brand Name: COROX OTW-L 85-BP
• Type of Device: LV LEAD
• Manufacturer (Section D): BIOTRONIK SE & CO. KG; woermannkehre 1; berlin 12359
• Manufacturer Contact: 6024 jean road; lake oswego, OR 97035 ; 8772459800
• MDR Report Key: 16308258
• MDR Text Key: 308893187
• Report Number: 1028232-2023-00641
• Device Sequence Number: 1
• Product Code: OJX
• UDI-Device Identifier: 04035479112172
• UDI-Public: (01)04035479112172(17)180630
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: P070008
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Company Representative
• Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup
• Report Date: 01/31/2023

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 02/06/2023
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Expiration Date: 06/30/2018
• Device Model Number: 368346
• Device Catalogue Number: SEE MODEL NO.
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Date Manufacturer Received: 02/08/2023
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Date Device Manufactured: 06/24/2016
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Outcome(s): Hospitalization; Life Threatening
• Patient Age: 71 YR
• Patient Sex: Male