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Combination product: yes.Upon receipt, the lead under complaint was subjected to an extensive analysis.The performance of the lead was scrutinized, including a visual, mechanical and electrical inspection.The insulation was found abraded through 12.5 cm proximal to the lead tip, which is assumed to be the root cause of the reported oversensing.The characteristics of this damage indicate unexpected, excessive wear on the lead.Thus, it is assumed that the lead was subject to severe mechanical stress in the implanted state.Causes for elevated stresses are difficult to determine.An accumulation of different factors may impact wear on the lead.These factors include interaction with atypical tissue, significant cardiac motion due to an adverse lead position including slack, or a potential increased ingrowth which had impact on the manoeuvrability of the lead.Furthermore, tortuous cardiac anatomy, high patient activity levels, and significant manual labour involving the upper body are known contributing factors.Furthermore, a cut into the insulation was found 23.5 cm distal to the df4 connector pin, which probably occurred during the explantation procedure.Prior to the analysis of the device, the quality documents accompanying the manufacturing process for this device were re-investigated.All production steps were performed accordingly, and in particular the final acceptance test proved the device functions to be as specified.In conclusion, the analysis did not reveal any sign of a material or manufacturing problem.
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