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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ST. JUDE MEDICAL, INC.(CRM-SYLMAR) ISOFLEX OPTIM LEAD; PERMANENT DEFIBRILLATOR ELECTRODES

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ST. JUDE MEDICAL, INC.(CRM-SYLMAR) ISOFLEX OPTIM LEAD; PERMANENT DEFIBRILLATOR ELECTRODES Back to Search Results
Model Number 1944/52
Device Problems High impedance (1291); Use of Device Problem (1670); Device Sensing Problem (2917)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 12/25/2023
Event Type  malfunction  
Event Description
It was reported that the patient presented for an implant procedure.During the procedure, the right atrial (ra) lead was unable to be implanted due to unspecified parameters and stability issues.The lead was not used, and a new lead was implanted.The patient was stable throughout the procedure.
 
Event Description
New information received notes that the ra lead also exhibited high pacing impedance and sensing measurements issue.
 
Manufacturer Narrative
The reported events were ¿the lead was not stable in all positioning¿, high pacing impedance and p-wave amp variation.As received, a complete lead was returned with all tines intact.The reported events of high pacing impedance and p-wave amp variation were not confirmed.Electrical testing and visual inspection of the lead did were normal.
 
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Brand Name
ISOFLEX OPTIM LEAD
Type of Device
PERMANENT DEFIBRILLATOR ELECTRODES
Manufacturer (Section D)
ST. JUDE MEDICAL, INC.(CRM-SYLMAR)
15900 valley view court
sylmar CA 91342
Manufacturer (Section G)
ST. JUDE MEDICAL, INC.(CRM-SYLMAR)
15900 valley view court
sylmar CA 91342
Manufacturer Contact
richard williamson
15900 valley view court
sylmar, CA 91342
MDR Report Key18499891
MDR Text Key332917300
Report Number2017865-2024-00991
Device Sequence Number1
Product Code NVY
UDI-Device Identifier05414734502320
UDI-Public05414734502320
Combination Product (y/n)Y
Reporter Country CodeIN
PMA/PMN Number
P960030
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,User Facility,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup,Followup
Report Date 02/22/2024
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 Lot NumberP000162785
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 12/25/2023
Initial Date FDA Received01/11/2024
Supplement Dates Manufacturer Received01/18/2024
02/21/2024
Supplement Dates FDA Received01/18/2024
02/22/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured02/08/2023
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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