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The icd was received for analysis.Prior to the analysis of the device, the quality documents accompanying the manufacturing process for this icd were re-investigated and all production steps were performed accordingly.Particularly the final acceptance test proved the device functions to be as specified.The ability of the device to deliver therapies was verified.The anti-bradycardia pacing pulses proved to be normal and in amplitude and frequency as programmed.A fibrillation signal was applied and the device delivered a defibrillation shock as specified, documenting a normal and expected sensing and shock delivery.In particular, the specified energy level was reached.The memory content of the device was thoroughly inspected.The inspection revealed an inconsistency between the amount of charge taken from the battery and the battery voltage, leading to the automatic detection of the eri battery status and a notification via home monitoring to ensure patient safety.At a next step, the device was opened and the inner assembly was inspected.The visual inspection of the inner assembly showed no anomalies.The overall current consumption of the electrical module was directly measured and proved to be normal and as expected.Therefore, the battery was sent to the manufacturer of the battery for further analysis.The manufacturing records of the battery were inspected, documenting that the battery parameters were within specification during the battery manufacturing.No anomalies were documented during the production process, associated with this battery.The battery was subjected to a visual and an electrical inspection as well as a microcalorimetry analysis.The visual inspection of the battery did not reveal any external signs of damage.The microcalorimetry analysis showed an elevated heat dissipation.In a next step, the battery was opened for destructive analysis.The inspection of the inner assembly identified an internal short circuit, which led to an elevated internal self-depletion within the battery.This finding is considered to be the root cause of the clinical observation.Despite this finding, the battery was proven to have sufficient capacity to support therapy capability for at least the specified time from eri to eos.In conclusion, the device was implanted for 67 months.The analysis revealed an elevated internal self-depletion within the battery, leading to the clinical observation.Based on the analysis all therapy functions of the device were entirely available while the device was implanted and in service.
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