inforMED

MEDTRONIC

Received Jul 18, 1994

Report 9438 · MDR key 9438

Device

Generic name

Pisces Quad Lead Kit

Model number

3487A

Catalog number

3487A

Lot number

LOT # L 32372

Patient

UNK

Narrative

Description of Event or Problem

DEFECTIVE LEAD - WHEN LEAD CONNECTED, NO STIMULATION. NEW LEAD HAD TO BE USED. NO INJURY/HARM TO PATIENT. REPORT SUBMITTED TO FDA AND USP.INVALID DATA - REGARDING SINGLE USE LABELING OF DEVICE. PATIENT MEDICAL STATUS PRIOR TO EVENT: INVALID DATA. INVALID DATA - REGARDING MULTIPLE PATIENT INVOLVEMENT.INVALID DATA - ON DEVICE SERVICE/MAINTENANCE. NO DATA - REGARDING DATE LAST SERVICED. SERVICE PROVIDED BY: INVALID DATA. INVALID DATA - SERVICE RECORDS AVAILABILITY.INVALID DATA - REGARDING WHETHER EVENT PRESENTS IMMINENT HAZARD. INVALID DATA - WHETHER DEVICE USED AS LABELED/INTENDED.INVALID DATA - REGARDING EVALUATION BY USER AFTER EVENT. METHOD OF EVALUATION: INVALID DATA. RESULTS OF EVALUATION: INVALID DATA. CONCLUSION: INVALID DATA. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: INVALID DATA. CORRECTIVE ACTIONS: NO DATA. INVALID DATA - ON DEVICE DESTROYED/DISPOSED OF STATUS.