FDA is notifying health care providers and patients that the Guidant Corporation is recalling certain of its implantable defibrillators and cardiac resynchronization therapy defibrillators. These devices can develop an internal short circuit without warning, resulting in failure to deliver a shock when needed. The devices affected by this notification are:
The devices are surgically implanted in persons who have a type of heart disease that creates the risk of a life-threatening heart arrhythmia (abnormal rhythm). The devices deliver an electrical shock to the heart to restore normal heart rhythm. The PRIZM 2 and RENEWAL devices are subject to different failures, resulting in the devices' inability to deliver an electrical shock during episodes of arrhythmia -- which could lead to a serious, life-threatening event for a patient. There have been two deaths reported to FDA suspected to be associated with this malfunction.
"FDA's first priority is patient safety," said Daniel Schultz, MD, Director of FDA's Center for Devices and Radiological Health. "We want to ensure that all patients who may be affected by this problem are notified and seek appropriate medical advice from their physicians."
FDA is not making a recommendation on whether individual patients who have one of the Guidant devices should have it removed and replaced. This is a decision that should be made by a patient in consultation with his or her physician, based on the specific medical situation of the patient. Removal and replacement of the device may pose some risk, so it is important that patients and physicians carefully discuss this matter before making a decision.
FDA advises patients to take the following steps:
Guidant also recently informed FDA that it is recalling another set of defibrillator devices called PRIZM AVT, VITALITY AVT, RENEWAL 3 AVT and RENEWAL 4 AVT. The company has said the devices are subject to a memory error, which may affect device performance. Currently, FDA is evaluating this information.
PACEMAKERS
The U.S. Food and Drug Administration (FDA) is notifying health care providers and patients that Guidant Corporation is voluntarily recalling certain pacemakers. A seal within the devices can leak, allowing moisture to affect the electronic circuits. This defect can cause the pacemakers to fail to provide pacing or can cause a rapid heart rate. Other unexpected device behaviors are also possible. The problems may occur without warning and can lead to loss of consciousness, and possibly heart failure and death.
Only the following models are affected by this recall. All were manufactured between November 25, 1997 and October 26, 2000.
* VIRTUS PLUS II and INTELIS II models available only outside the U.S.
Guidant announced the initiation of a voluntary recall on July 18, 2005. The recall action consisted of a letter to physicians that describes the problem and provides recommendations about how to minimize the risk of pacemaker failure.
The FDA has classified Guidant's action as a Class I recall. Recall classifications can fall into one of three categories, with Class I being the most serious. These numerical classifications are based on the probability that the device failure could lead to adverse health effects. In a Class I recall, there is a reasonable probability that the malfunctioning device will cause serious adverse health consequences or death.
"Pacemakers are complex medical devices that can extend and improve the lives of many people who have heart rate abnormalities. However, they are not perfect and can malfunction," said Daniel Schultz, M.D., Director, FDA's Center for Devices and Radiological Health. "We are notifying patients and physicians about this important safety matter so they can take prompt action to reduce the risk of serious health consequences."
Some patients are very dependent on pacemakers to maintain an adequate heart rate. For these patients, failure of the device to provide pacing output can cause sudden faintness or loss of consciousness, and can result in death. The leakage defect can also cause a sustained rapid heart rate, which can cause heart failure and result in death.
While the failures can occur without warning, sometimes a leak-related malfunction can be detected by a physician before the malfunction causes serious problems. Guidant has provided information to physicians about ways to identify a leak-related malfunction. However, Guidant is not aware of any test that will show if a normally functioning pacemaker is likely to fail in the future.
As of July 11, 2005, Guidant had received reports that 69 pacemakers may have failed because of the leakage. Twenty of the devices were confirmed to have stopped providing pacing output, resulting in loss of consciousness in five patients. Guidant also received reports of two patients who had sustained pacing at a rapid rate. A patient whose device exhibited sustained pacing at a rapid rate was admitted to the hospital and later died. The device problem could not be confirmed as leakage since the device was not returned.
Approximately 18,000 of the affected devices remain in service in the United States and an additional 10,000 are in service in other countries. Guidant estimates that the failure rate from the leakage defect will be between 0.17% and 0.51% (i.e., between 1.7 per one thousand and 5.1 per one thousand) over the remaining lifetime of the devices. It is possible that the actual failure rate will be greater than this, in part, because some past failures may not have been reported to Guidant.
The FDA is not making a recommendation about whether a patient who has one of the Guidant pacemakers affected by this recall should have it replaced. This is a decision that should be made by the patient in consultation with his or her physician, based on the patient's history and medical condition. Removal and replacement of the device may pose some risk, so it is important that patients and physicians carefully discuss this matter before making a decision.
The FDA concurs with Guidant's proposed recommendation to patients, which are consistent with the physician recommendations previously set forth in Guidant's July 18 letter:
See your doctor if you have received a Guidant defibrillator device and you are concerned about your safety. In addition, it may be important to contact a Guidant attorney who can help you protect your legal rights. Please keep in mind that there may be time limits within which you must commence suit.
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