inforMED
MalfunctionLHG

ITREL

Received Dec 13, 2001 · Event occurred Jul 24, 2001

Report 6000030-2001-00967 · MDR key 367264

Device

Generic name

Lead

Manufacturer

Medtronic Inc..

Model number

3986ILC

Catalog number

NA

Lot number

N24261

Product problems

  • Shock, electrical
  • Explanted
  • Knotted
  • Shielding, inadequate

Patient

46 YR

  • Burn(s)
  • Other (for use when an appropriate patient code cannot be identified)
  • Electric Shock
  • Surgical procedure, additional

Narrative

Description of Event or Problem

HCP REPORTED PATIENT EXPERIENCED BURNING AT GENERATOR, SHOCKING & INTERMITTENT STIMULATION SINCE IMPLANT. AT TIME OF EXPLANT IT WAS NOTED THAT THE INSULATION HAD PULLED AWAY FROM LEAD BODY EXPOSING WIRES. THE DEVICE WAS EXPLANTED AND RETURNED TO THE MANUFACTURER FOR ANALYSIS. A FOLLOW UP REPORT WILL BE SENT WHEN ADDITIONAL INFORMATION IS RECEIVED.