Anapol Schwartz - Attorneys at Law
sprint-fidelis

Sprint Fidelis Medtronic defibrillators

Do you have a Sprint Fidelis claim?

Please fill out the form below to see if you have a Sprint Fidelis Defibrillator Lead Wire case.

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PERSONAL INFORMATION
First Name:
Last Name:
E-mail Address:
Phone () - ext.
Alternative Phone () - ext.
Address:
City:
State:
Zipcode:
Date of Birth:
MEDICAL INFORMATION
Which manufacturer's device has been implanted?
What was the date you received your implant?
Which model lead wires were used?
If 'Other' Please Specify:
Did your lead wires break or fracture? Yes No
What complications have you had from the defibrillator leads (wires, electrodes)?
Were your lead wires replaced or capped? Yes No
What recommendations have your doctors made about replacing these wires (leads)?
If wires replaced or implant removed, what was the date of removal or replacement of your implant or wires?
Please be specific and tell us about your experience with the Defibrillator and Leads:
Please enter any questions or comments/questions in this space: