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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT ISOFLEX OPTIM LEAD; PERMANENT PACEMAKER ELECTRODE

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ABBOTT ISOFLEX OPTIM LEAD; PERMANENT PACEMAKER ELECTRODE Back to Search Results
Model Number 1944/52
Device Problems Failure to Capture (1081); Failure to Sense (1559); No Pacing (3268)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 05/05/2023
Event Type  malfunction  
Event Description
It was reported that during a follow up in clinic, loss of sensing and loss of pacing was noted on the right atrial (ra) lead.The device was reprogrammed to resolve the event.The patient was in stable condition.
 
Event Description
Additional information was received indicating loss of pacing did not occur.Loss of capture was noted on the right atrial (ra) lead.
 
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Brand Name
ISOFLEX OPTIM LEAD
Type of Device
PERMANENT PACEMAKER ELECTRODE
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 Key16963714
MDR Text Key315767086
Report Number2017865-2023-20524
Device Sequence Number1
Product Code NVY
UDI-Device Identifier05414734502320
UDI-Public05414734502320
Combination Product (y/n)Y
Reporter Country CodeIT
PMA/PMN Number
P960030
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,Followup
Report Date 06/21/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number1944/52
Device Catalogue Number1944-52
Device Lot NumberP000155600
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 05/05/2023
Initial Date FDA Received05/19/2023
Supplement Dates Manufacturer Received06/01/2023
06/21/2023
Supplement Dates FDA Received06/06/2023
06/21/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured10/12/2022
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
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