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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT DURATA STS OPTIM ACTIVE FIXATION, DF-4 CONNECTOR; DEFIBRILLATION LEAD

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ABBOTT DURATA STS OPTIM ACTIVE FIXATION, DF-4 CONNECTOR; DEFIBRILLATION LEAD Back to Search Results
Model Number 7122Q/58
Device Problems Failure to Capture (1081); Retraction Problem (1536)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 02/20/2023
Event Type  Injury  
Event Description
It was reported that an increase in the capture threshold resulting in a loss of capture was observed on the right ventricular (rv) lead.During the revision procedure, the helix of the rv lead was unable to retract.As a result, the rv lead was explanted and replaced to resolve the event.The patient was stable and will continue to be monitored.
 
Manufacturer Narrative
The reported events were failure to capture and a helix mechanism issue.As received, only the distal portion of the lead was returned in one piece for analysis.The reported event of the helix mechanism issue was confirmed.Visual inspection revealed the helix to be partially extended and clogged with dried blood.After cutting the partial lead and cleaning the distal region of the partial lead, the helix could be extended and retracted by applying torque directly to the inner coil.The measured full helix extension length was within specification.The cause of the helix mechanism issue was isolated to the helix being clogged with dried blood and blood on the inner coil.The reported event of failure to capture was not confirmed on this portion of the lead.Electrical testing did not reveal any indication of conductor fractures or internal shorts.Visual and x-ray inspections of the partial lead did not find any anomalies.
 
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Brand Name
DURATA STS OPTIM ACTIVE FIXATION, DF-4 CONNECTOR
Type of Device
DEFIBRILLATION LEAD
Manufacturer (Section D)
ABBOTT
15900 valley view court
sylmar CA 91342
Manufacturer (Section G)
ABBOTT
15900 valley view court
sylmar CA 91342
Manufacturer Contact
richard williamson
15900 valley view court
sylmar, CA 91342
MDR Report Key16463750
MDR Text Key310469608
Report Number2017865-2023-11479
Device Sequence Number1
Product Code NVY
UDI-Device Identifier05414734503174
UDI-Public05414734503174
Combination Product (y/n)Y
Reporter Country CodeSP
PMA/PMN Number
P950022
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 04/17/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number7122Q/58
Device Catalogue Number7122Q-58
Device Lot NumberA000130484
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 02/21/2023
Initial Date FDA Received03/01/2023
Supplement Dates Manufacturer Received03/30/2023
Supplement Dates FDA Received04/17/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured09/08/2022
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
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