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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL INFINITY¿ 7 IMPLANTABLE PULSE GENERATOR; DBS PULSE GENERATOR

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ABBOTT MEDICAL INFINITY¿ 7 IMPLANTABLE PULSE GENERATOR; DBS PULSE GENERATOR Back to Search Results
Model Number 6663
Medical Device Problem Code Battery Problem (2885)
Health Effect - Clinical Code Failure of Implant (1924)
Date of Event 10/10/2023
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
Section b3: event date is estimated.
 
Event or Problem Description
It was reported that the patient's ipg had received the elective replacement indicator (eri) message.Surgical intervention was undertaken on (b)(6) 2023 wherein the patient's ipg was explanted, replaced, and therapy was restored.
 
Additional Manufacturer Narrative
A system displaying ¿low battery warning¿ message was reported to abbott.The ipg was explanted and replaced.Therapy was restored.The results of the investigation are inconclusive as the product was not returned for analysis.Based on the information received, the cause of the reported event could not be conclusively determined.
 
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Brand Name
INFINITY¿ 7 IMPLANTABLE PULSE GENERATOR
Common Device Name
DBS PULSE GENERATOR
Manufacturer (Section D)
ABBOTT MEDICAL
6901 preston rd
plano TX 75024
Manufacturer (Section G)
ABBOTT MEDICAL
6901 preston rd
plano TX 75024
Manufacturer Contact
heidi syndergaard
6901 preston road
plano, TX 75024
9723098000
MDR Report Key18034727
Report Number1627487-2023-05114
Device Sequence Number15495538
Product Code MHY
UDI-Device Identifier05415067020239
UDI-Public05415067020239
Combination Product (Y/N)N
Initial Reporter StateCA
Initial Reporter CountryUS
PMA/510(K) Number
P140009
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2022
Device Explanted Year2023
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 11/28/2023
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
Operator of Device Health Professional
Device Expiration Date07/16/2023
Device Model Number6663
Device Lot Number8271824
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer Not provided
Supplement Date Received by Manufacturer11/05/2023
Initial Report FDA Received Date10/30/2023
Supplement Report FDA Received Date11/28/2023
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured01/04/2022
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Outcome Attributed to Adverse Event Other;
Patient Age56 YR
Patient SexFemale
Patient Weight73 KG
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