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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 1944/46
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Death
Event or Problem Description
It was reported that the patient had deceased due to an unknown cause.There is no known allegation from a health care professional that suggests that the death was device related.No additional information was reported.
 
Additional Manufacturer Narrative
The lead was returned due to patient death.As received, a partial lead (only the connector) was returned in one piece for analysis.Electrical, mechanical, and visual analysis was normal with no anomalies found.
 
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Brand Name
ISOFLEX OPTIM LEAD
Common Device Name
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
navpreet singh
15900 valley view court
sylmar, CA 91342
MDR Report Key22879788
Report Number2017865-2025-98440
Device Sequence Number14874914
Product Code NVY
UDI-Device Identifier05414734502313
UDI-Public(01)05414734502313(10)A000126604(17)250531
Combination Product (Y/N)Y
Initial Reporter StateOR
Initial Reporter CountryUS
PMA/510(K) Number
P960030
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2022
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source User Facility
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 08/22/2025
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? No
Operator of Device Health Professional
Device Expiration Date05/31/2025
Device Model Number1944/46
Device Lot NumberA000126604
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer08/04/2025
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/04/2025
Initial Report FDA Received Date08/22/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/08/2022
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 Death;
Patient SexFemale
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