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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL (CRM-SYLMAR) ISOFLEX OPTIM LEAD; Permanent defibrillator electrodes

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ABBOTT MEDICAL (CRM-SYLMAR) ISOFLEX OPTIM LEAD; Permanent defibrillator electrodes Back to Search Results
Model Number 1948/58
Medical Device Problem Code Over-Sensing (1438)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the patient presented to clinic for a follow up.It was noted that the right ventricular (rv) lead exhibited oversensing noise resulting in pacing inhibition.The rv lead was capped and replaced on (b)(6) 2026.The patient was in stable condition.
 
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Brand Name
ISOFLEX OPTIM LEAD
Common Device Name
Permanent defibrillator electrodes
Manufacturer (Section D)
ABBOTT MEDICAL (CRM-SYLMAR)
15900 valley view court
sylmar CA 91342
Manufacturer (Section G)
ABBOTT MEDICAL (CRM-SYLMAR)
15900 valley view court
sylmar CA 91342
Manufacturer Contact
navpreet singh
15900 valley view court
sylmar, CA 91342
MDR Report Key25648954
Report Number2017865-2026-13359
Device Sequence Number14919469
Product Code NVY
UDI-Device Identifier05414734502351
UDI-Public(01)05414734502351(10)P000055952(17)201231
Combination Product (Y/N)Y
Initial Reporter StateMA
Initial Reporter CountryUS
PMA/510(K) Number
P960030
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2018
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) 06/29/2026
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? Yes
Operator of Device Health Professional
Device Expiration Date12/31/2020
Device Model Number1948/58
Device Lot NumberP000055952
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 06/16/2026
Initial Report FDA Received Date06/29/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured01/19/2018
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
Concomitant Medical Products
and Therapy/Usage Dates
ISOFLEX OPTIM J LEAD.
Outcome Attributed to Adverse Event Required Intervention;
Patient Age77 YR
Patient SexMale
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