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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ST. JUDE MEDICAL, INC.(CRM-SYLMAR) DURATA STS OPTIM ACTIVE FIXATION; Implantable cardioverter defibrillator (non-CRT)

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ST. JUDE MEDICAL, INC.(CRM-SYLMAR) DURATA STS OPTIM ACTIVE FIXATION; Implantable cardioverter defibrillator (non-CRT) Back to Search Results
Model Number 7120/65
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Codes Unspecified Infection (1930); Pocket Erosion (2013)
Date of Event 01/20/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the patient presented to the emergency room due to tenderness at the device pocket site, accompanied by wound dehiscence and pocket erosion.The physician explanted the entire implantable cardioverter-defibrillator system due to infection.The patient remained in stable condition throughout the procedure.
 
Additional Manufacturer Narrative
A device history record (dhr) review was performed and all required manufacturing processes and inspections steps were confirmed to be completed per the requirements.The device met specifications prior to leaving abbott manufacturing facilities.Review of the sterilization records confirmed normal sterilization cycles for the products.The cause of infection could not be determined.
 
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Brand Name
DURATA STS OPTIM ACTIVE FIXATION
Common Device Name
Implantable cardioverter defibrillator (non-CRT)
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 Key24471519
Report Number2017865-2026-04126
Device Sequence Number16021684
Product Code LWS
UDI-Device Identifier05414734502092
UDI-Public(01)05414734502092(10)3368193(17)140430
Combination Product (Y/N)Y
Initial Reporter CountryCA
PMA/510(K) Number
P950022
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2011
Device Explanted Year2026
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 02/28/2026
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 Date04/30/2014
Device Model Number7120/65
Device Lot Number3368193
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 02/09/2026
Initial Report FDA Received Date02/27/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured04/12/2011
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 SexUnknown
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