Riata and Riata ST – all silicone coated models 를 위한 안전성 경고 / 현장 안전성 서한

Medicines and Healthcare products Regulatory Agency에 따르면, 해당 안전성 경고 / 현장 안전성 서한 는 United Kingdom 에서 St Jude Medical 에 의해 제조된 제품과 관련되어 있습니다.

이것은 무엇인가요?

현장 안전성 서한은 의료기기 제조사 또는 제조사 대리인이 시중에 유통되고 있는 자사 의료기기 제품에 대하여 취할 수 있는 조치를 알리는 소통방식입니다. 주요 대상층은 보건의료업계 종사자와 의료기기 사용자들입니다. 여기에는 회수(recall) 조치와 경고도 포함될 수 있습니다.

데이터에 대해 더 자세히 알아보기 여기
  • 사례 유형
    Safety alert / Field Safety Notice
  • 사례 ID
    MDA/2012/061
  • 사례 연번
    CON184434
  • 날짜
    2012-09-10
  • 사례 출판 날짜
    2012-09-10
  • 사례 국가
  • 사례 출처
    MHRA
  • 사례 출처 URL
  • 비고 / 경고
    Data from the United Kingdom is current through April 2019. All of the data comes from the Medicines and Healthcare products Regulatory Agency, except for the categories Manufacturer Parent Company and Product Classification.
    The Parent Company and the Product Classification were added by ICIJ.
    The parent company information is based on 2017 public records. The device classification information comes from FDA’s Product Classification by Review Panel, based on matches of recall data from the U.S. and the United Kingdom.
  • 데이터 추가 비고
  • 원인
    Risk of inappropriate shock or therapy failure due to wear of lead insulation after implantation. these patient follow-up recommendations replace those given previously in mda/2010/095 and mda/2011/112. in december 2011, the mhra issued a medical device alert (mda/2011/112) recommending enhanced patient follow-up for all patients implanted with riata and riata st lead models. at that time the frequency of follow-up was stratified according to lead model. current evidence suggests that the difference in prevalence of externalised cables between 8fr and 7fr lead models is decreasing. st jude medical has recently issued a field safety notice (dated 13 july 2012) detailing phase i of a riata lead evaluation study to investigate the prevalence of externalised cables using fluoroscopy. the clinical significance of externalised cables will not, however, be evident until phase ii of the study is completed; this is unlikely to be before the end of 2013. for this reason this medical device alert is focusing on detection of early signs of functional lead failure, as these lead models continue to fail at a higher rate.
  • 조치
    Continue to follow up all patients implanted with Riata or Riata ST ICD lead models to identify any changes in lead performance, according to your own standard procedures (see further advice below). Undertake this: at three-month intervals (in clinic or via remote monitoring) to - monitor for HV lead noise using an unused EGM channel turn on RV AutoCapture™ (or equivalent) pacing to monitor pacing thresholds  and at six-month intervals (in clinic) to - ensure high voltage lead integrity (HVLI)  testing is performed. At box change, if a decision is made to continue to use the lead, ensure that the replacement device has remote/advanced monitoring capabilities. Consider the need for further examination e.g. by ECG or fluoroscopy*, if a lead failure is suspected. If a lead failure is confirmed, the risks and benefits of lead replacement options should be evaluated on a case-by-case basis in discussion with the patient. Note: Prophylactic lead explantation is not recommended, other than in exceptional clinical circumstances. * In all cases, the benefit of fluoroscopic screening should be weighed against the risks from radiation exposure on an individual patient basis, in line with the requirements of The Ionising Radiation (Medical Exposure) Regulations 2000. Further advice Where appropriate for patients, follow-up should continue to include: > provocative testing (e.g. shoulder/arm movements and deep respiration), which may help reveal an   intermittent problem > increasing the detection time of the VT zone to reduce the risk of oversensing and inappropriate shocks > ensuring the SVT discriminators are on, where applicable > ensuring that the lead impedance alarms are programmed on. Remind patients of the importance of contacting their follow-up clinic as soon as possible in the event of therapy delivery and/or the onset of any patient alert. Report all lead adverse incidents to the MHRA and to St Jude Medical.

Device

  • 모델명 / 제조번호(시리얼번호)
  • 제품 설명
    Implantable cardioverter defibrillator (ICD) leads. Riata and Riata ST – all silicone coated models.
  • Manufacturer

Manufacturer

  • 제조사 모회사 (2017)
  • 제조사 의견
    “We are in constant communication with regulatory agencies and competent authorities worldwide which allows us to implement global recalls or in-country communication quickly and effectively,” Abbott, which now owns St. Jude Medical told ICIJ in a statement. In addition to sending global notices to physicians worldwide, we also make sure that product advisories are available online and classification of product recalls and product advisories are determined by global regulatory bodies which can impact the timing in any given country. MD companies follow varying regulations in different countries. In come countries software is not regulated so a recall in one country related to software would not be classified as a recall or field action in another. In addition, review cycles within the regulatory process can be different in each country which can impact communication and recall timing.
  • Source
    MHRA