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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 Capturing Problem (2891)
Health Effect - Clinical Code Unspecified Infection (1930)
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the presented to the hospital for atrial lead revision procedure due to high capture threshold.After the procedure was started, infection was noted at the patient's device pocket.The pacemaker, the right atrial lead and the right ventricular lead were explanted due to the infection and were reimplanted on the right side.The patient was stable throughout the procedure.
 
Additional Manufacturer Narrative
The sterilization records were reviewed and no evidence of abnormal sterilization cycle was found.The results of the investigation are inconclusive since the lead was not returned for analysis.Based on the information received, the cause of the reported incident could not be conclusively determined.
 
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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 Key23023032
Report Number2017865-2025-99848
Device Sequence Number18505395
Product Code NVY
UDI-Device Identifier05414734502313
UDI-Public(01)05414734502313(10)A000130695(17)250831
Combination Product (Y/N)Y
Initial Reporter StateLA
Initial Reporter CountryUS
PMA/510(K) Number
P960030
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Device Explanted Year2025
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,User Facility,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 09/11/2025
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 Date08/31/2025
Device Model Number1944/46
Device Lot NumberA000130695
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 08/25/2025
Initial Report FDA Received Date09/10/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured09/13/2022
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 Required Intervention;
Patient Age78 YR
Patient SexFemale
Patient Weight82 KG
Patient EthnicityNon Hispanic
Patient RaceBlack Or African American
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