MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2020-01-03 for BIPOLAR TEMPORARY MYOCARDIAL PACING LEAD 6495 manufactured by Medtronic Heart Valves Division.
[181981674]
Date of event and explant date are year valid only. Relevant history: the device manufacturer of the prosthetic aortic valve is unknown. Product analysis: no product was returned. Conclusion: without the return of the product, no definitive conclusion can be made regarding the clinical observation. If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10
[181981675]
Medtronic received information from a patient's spouse that an unknown duration post implant and subsequent removal of this temporary pacing lead, magnetic resonance imaging (mri) revealed that a portion of the pacing lead remained in the patient's body. The duration that the temporary pacing lead was implanted prior to removal was not reported. No interventions were performed to remove the portion of the lead remaining in the body, and no adverse patient effects related to the lead were reported.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2025587-2020-00033 |
| MDR Report Key | 9547714 |
| Report Source | COMPANY REPRESENTATIVE,FOREIG |
| Date Received | 2020-01-03 |
| Date of Report | 2020-01-03 |
| Date of Event | 2018-11-30 |
| Date Mfgr Received | 2019-12-15 |
| Date Added to Maude | 2020-01-03 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | PAULA BIXBY |
| Manufacturer Street | 8200 CORAL SEA STREET NE |
| Manufacturer City | MOUNDS VIEW MN 55112 |
| Manufacturer Country | US |
| Manufacturer Postal | 55112 |
| Manufacturer Phone | 7635055378 |
| Manufacturer G1 | MEDTRONIC HEART VALVES DIVISION |
| Manufacturer Street | 1851 E DEERE AVE |
| Manufacturer City | SANTA ANA CA 92705 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 92705 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | BIPOLAR TEMPORARY MYOCARDIAL PACING LEAD |
| Generic Name | ELECTRODE, PACEMAKER, TEMPORARY |
| Product Code | LDF |
| Date Received | 2020-01-03 |
| Model Number | 6495 |
| Catalog Number | 6495 |
| Lot Number | UNKNOWN |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MEDTRONIC HEART VALVES DIVISION |
| Manufacturer Address | 1851 E DEERE AVE SANTA ANA CA 92705 US 92705 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Life Threatening | 2020-01-03 |