When a Pacemaker Fails, Moves or Isn’t Checked: What Should Happen Next
Summary
A pacemaker is a small device that keeps the heart beating at a safe rate. For most people it works quietly for years. This guide is for people whose pacemaker lead moved, whose device became infected or stopped working properly, or whose warning signs weren’t acted on. It explains how a pacemaker works, with a diagram, the known risks, the checks that should happen, and when a problem might point to care that fell short.
Quick answer · updated November 2026
Pacemaker problems include a lead moving out of place, infection, a collapsed lung, bleeding and device faults. Many are recognised risks that happen even with good care. But dizziness, fainting or a slow pulse after a pacemaker should be checked promptly, and regular device checks should not be missed. If they were, you can ask for your device check reports and records.
A pacemaker at a glance
- 1DecidingYou should understand why you need it and what the risks are.
- 2InsertionThe device goes under the skin; a lead runs through a vein into the heart.
- 3First weeksLeads are most likely to move early. Limit arm movement as advised.
- 4Regular checksUsually every 6 to 12 months, sometimes remotely.
- 5If symptoms returnDizziness, fainting or breathlessness needs prompt review.
At any stage: fainting, chest pain, severe breathlessness or a very slow or fast pulse is an emergency. Call 000.
Dad was seventy-eight and stubborn about everything except his heart. After he fainted in the garden, the cardiologist said his heart was pausing, and a pacemaker would fix it. He went home the next day with a small square bump under his left collarbone, joking that he was bionic.
Ten days later he rang me. “I’ve gone a bit funny again,” he said. He’d been dizzy at the shops and had to sit on the kerb.
We rang the hospital. A nurse said some dizziness was normal while he got used to it, and to keep his follow-up appointment in six weeks.
Four days after that, he fainted in the shower and hit his head on the tiles.
A composite story, drawn from the experiences of many families I have worked with, combined and changed so that no one can be identified. It does not describe any individual client.
If you or someone you love had a pacemaker fitted and things didn’t go as they should, I want you to know that your questions are reasonable. Pacemakers are common and usually very safe, but when one fails or a warning sign is missed, the consequences can be frightening.
This guide covers how a pacemaker works, the known risks, the checks that should happen, what your records should show, and how the law looks at it.
Why I can write this
I have been a medical negligence lawyer since 2014 and have worked on many hundreds of claims, including many involving implanted medical devices. My doctorate looked at patterns of failure in medical negligence. I am not medically qualified. The clinical facts in this article are checked against named sources, listed in the references, and I explain how I work in our editorial standards.
Start with your question
- How does a pacemaker work?
- What are the risks of a pacemaker?
- What happens if a pacemaker lead moves?
- How often should a pacemaker be checked?
- What symptoms mean a pacemaker isn’t working?
- What if my pacemaker is recalled?
- Could this be medical negligence?
How a pacemaker works
A pacemaker is a small battery-powered device placed under the skin, usually below the collarbone. One or more thin wires, called leads, run through a vein into the heart. The device watches the heart’s rhythm and sends a small electrical signal when the heart is too slow or pauses.1 Most people go home the same day or the next.1
A pacemaker and its lead
Where it sits
The device lies under the skin. The lead carries signals into the heart.
- The device (generator). Holds the battery and electronics. It can become infected or wear through the skin.
- The lead. Runs through a vein. It can move out of place, especially in the first weeks.
- The lead tip. Sits against the heart muscle. If it loses contact, the heart may not be paced.
A simplified drawing, not to scale. Some pacemakers have two or three leads, and some have none.
Before the procedure
Before you agree, you should understand why a pacemaker is recommended, what type, and the risks. You should also be told what to avoid while the leads settle, and who to call if symptoms come back.
Questions to ask
- Why do I need a pacemaker, and what are the alternatives?
- What are the main risks for someone like me?
- What should I avoid in the first weeks?
- When will my device be checked, and by whom?
- Who do I call if I feel dizzy or faint again?
The risks
healthdirect lists the possible complications of inserting a pacemaker as including bleeding, bruising, a collapsed lung (pneumothorax), blood collecting around the heart (cardiac tamponade), a blood clot in an arm vein, wound infection that may mean removing the pacemaker, a lead moving out of place, the device wearing through the skin, and a pacemaker fault, which it notes can be life-threatening.1
When a lead moves
Definition
Lead displacement means a pacemaker lead has moved from where it was placed in the heart. The pacemaker may then fail to sense the heart or to pace it.
In plain terms: the wire has slipped, so the pacemaker may not be doing its job.
A lead moving out of place is a recognised complication.1 It is why people are told to avoid strenuous activity and lifting the arm on the pacemaker side for a few weeks.1 If symptoms that led to the pacemaker come back, a device check and chest X-ray can usually show whether the lead has moved. The question is whether that check happens promptly.
Regular device checks
Pacemakers need regular checks of the battery, the leads and the settings, typically every 6 to 12 months.1 The battery usually lasts many years before the device is replaced.2 A missed check can mean a failing lead or a low battery goes unnoticed.
Expected, worth a review, or emergency
Usually expected
- Bruising and soreness at the wound
- A visible bump under the skin
- Tiredness for a few days
In plain terms: sore, but improving.
Call your device clinic today
- Dizziness or feeling faint
- Hiccups that won’t stop
- Redness, swelling or fluid at the wound
- The skin over the device thinning
In plain terms: ask for a device check, not just reassurance.
Emergency
- Fainting or collapse
- Chest pain or severe breathlessness
- A very slow or very fast pulse
- Fever with a hot, swollen wound
In plain terms: call 000.
After a problem is found
If a lead has moved or a device has failed, the usual fix is a further procedure to reposition or replace the lead or the device. An infected system may need to be removed completely, with a new one placed once the infection has cleared.1 That can mean more time in hospital, more antibiotics, and another wound to heal.
It is worth writing down, while it is fresh, the dates you noticed symptoms, who you spoke to, and what you were told. Families often find that a simple timeline makes clear how long a problem was present before anyone checked. If an older parent was involved, our guide to making a complaint or a claim explains the difference between the two paths.
Falls and injuries
When a pacemaker isn’t working, the first sign is often a faint or a fall. For an older person, a fall can bring its own injuries: a broken hip, a head injury, or a loss of confidence that changes how they live. Those consequences are part of the harm the law looks at.
Device faults and recalls
Sometimes the problem is the device itself. Recalls of cardiac devices are published by the Therapeutic Goods Administration, and you can ask your cardiologist whether your model is affected. Our medication, drug and device harm page explains how claims about faulty devices differ from claims about care.
After the fall, the emergency doctor did a device check and an X-ray within the hour. The lead had slipped out of place. Dad went back to theatre the next morning to have it repositioned.
He needed stitches in his scalp, and he was never quite as steady on his feet again.
When I got his records, the phone call was there: “Pt reports dizziness. Advised normal post-PPM. Keep follow-up.” Nobody had asked about his pulse or offered a device check.
I read it at his kitchen table while he did the crossword. “Ten days,” I said. “They had ten days.” He shrugged and said the bump was still his favourite party trick. I wanted to know why a check that took an hour hadn’t happened sooner.
A composite story, drawn from the experiences of many families I have worked with, combined and changed so that no one can be identified. It does not describe any individual client.
What to look for in the records
Your records are often where the story becomes clear. You have a right to access your own health information. In NSW the Health Records and Information Privacy Act 2002 covers both public and private providers, and the Information and Privacy Commission explains how to ask.3 Our step-by-step guide to getting your medical records in Australia walks you through it.
| Record | Why it matters |
|---|---|
| Referral and consent | Show why the pacemaker was recommended and which risks were explained. |
| Procedure report | Records where the leads were placed and the measurements at the time. |
| Post-procedure X-ray | Shows where the lead sat on the first day, for comparison. |
| Device check reports | Show lead measurements, battery and settings at each check. |
| Phone and triage notes | Show what symptoms you reported and what advice was given. |
| Emergency notes | Show what was found when the problem was diagnosed. |
| Your own diary, photos and messages | Notes made at the time are evidence too. Keep them. |
How the law looks at it
A pacemaker complication is not automatically negligence. Leads move and infections happen even with careful care. The legal questions are whether the procedure, the follow-up and the response to your symptoms met the standard expected, and whether any shortfall caused harm.
A claim usually turns on three questions: whether the care fell below what peers would widely accept as competent practice (section 5O of the Civil Liability Act 2002 (NSW))4, whether that shortfall probably caused harm you wouldn't otherwise have had (Tabet v Gett)5, and, where it matters, whether you were told the material risks first (Rogers v Whitaker)67. Our guide to how a medical negligence claim works explains each one in plain terms.
In a pacemaker case, the questions might be: was the lead placed and secured properly? Were you told what to avoid while it settled? When you reported symptoms, were they taken seriously and was a device check offered? Were regular checks done, and were warning signs on them acted on?
In plain terms, the question is whether a prompt device check would probably have found the problem before you fainted, fell or were otherwise harmed.
For a pacemaker, that would usually include the risks of lead displacement, infection, collapsed lung and device fault.
Who can claim, and when
The person who had the pacemaker can claim. If they have died, their family may have a claim. In NSW, time usually runs from when you knew, or ought to have known, enough to claim, not from the treatment itself, and courts can sometimes extend it, so an old injury may still count. See time limits in NSW or other states, and ask early.
More: complaint or claim? · how a claim is paid for · what a claim can cover
In my practice
In pacemaker files, I most often see a gap between a reported symptom and a device check. A person rings to say they feel dizzy, and the advice is to wait for the routine appointment. The device check, when it finally happens, takes minutes and shows the problem plainly. Reading the phone notes often helps families understand that their concern was reasonable at the time.
Both things can be true
The team that fitted the pacemaker may have saved your life, and the follow-up may still have fallen short. You can be grateful for the device and still want to know why a warning sign wasn’t acted on.
The bigger picture
Pacemakers are among the most common heart procedures in Australia, and most people never have a problem. You can check a cardiologist’s registration on the Ahpra public register,8 and complaints about care in NSW can go to the Health Care Complaints Commission.9 Our guide to getting your medical records explains how to ask for device check reports.
Support
You don't have to work through this alone. These services can help:
- Lifeline, 24-hour crisis support: 13 11 14 (listed on healthdirect's helplines page)10
- Beyond Blue, anxiety and depression support: 1300 22 4636
- Medicare Mental Health, help finding mental health support: 1800 595 212
- healthdirect, 24-hour nurse advice: 1800 022 222
- Health Care Complaints Commission (NSW): 1800 043 159
A daughter at her father’s kitchen table now knows that the dizziness he reported was the warning it seemed to be. You deserve that clarity too.
With care,
Rosemary
Frequently asked questions
What happens if a pacemaker lead moves?
The pacemaker may stop sensing or pacing the heart properly. It is usually fixed with a procedure to reposition the lead.
How often should a pacemaker be checked?
Typically every 6 to 12 months, and sooner if symptoms return.
What are signs my pacemaker isn’t working?
Dizziness, fainting, breathlessness, a slow pulse or persistent hiccups should be checked promptly.
Is pacemaker infection serious?
It can be. An infected pacemaker may need to be removed and replaced.
How long does a pacemaker battery last?
Usually many years. One Victorian source says about 5 to 15 years depending on the device.
Can I claim if my pacemaker failed?
You may well have a claim if the care fell below the accepted standard and that caused harm, or if the device was faulty.
Questions about your pacemaker?
When you're ready, and not before, I can look at what happened and help you understand your options.
Medical device guides
- When a pacemaker fails, moves or isn’t checked: what should happen next (you are here)
- The Exactech knee recall: what it means if your knee is failing
- Spinal cord stimulator lead migration
- When a Nexplanon implant is inserted incorrectly
Part of our guide to medication, drug and device harm. Not sure where you stand? Try the free claim checker.
References
- healthdirect. Inserting a pacemaker.
- Better Health Channel (Victoria). Implantable cardiac devices.
- Information and Privacy Commission NSW. Fact sheet: Accessing your health information in NSW.
- Civil Liability Act 2002 (NSW) s 5O, Standard of care for professionals.
- Tabet v Gett [2010] HCA 12.
- Rogers v Whitaker [1992] HCA 58; (1992) 175 CLR 479.
- Australian Commission on Safety and Quality in Health Care. Informed consent.
- Australian Health Practitioner Regulation Agency. Register of practitioners.
- Health Care Complaints Commission NSW. Home page.
- healthdirect Australia. Mental health helplines.
Stories in this article are composites, drawn from the experiences of many families I have worked with, combined and changed so that no one can be identified. They do not describe any individual client.
Dr Rosemary Listing, PhD (Law), Medical negligence lawyer since 2014 · Of Counsel, Peter Evans & Associates. Rosemary's doctorate examined patterns of failure in medical negligence, and she teaches health law at the University of Newcastle. She is not medically qualified. About Rosemary.
Last updated: 10 November 2026 · First published: 10 November 2026 · Next review: May 2027
Cite this article: Listing R. When a pacemaker fails, moves or isn’t checked: what should happen next. Reframe Legal. Published 10 November 2026. https://reframelegal.com/pacemaker-failure/
This article is general information, not legal or medical advice. It does not create a lawyer–client relationship. Speak to your treating clinicians about your health, and get legal advice about your own situation.
If you are in danger or need urgent medical help, call 000. For crisis support, call Lifeline on 13 11 14.
Legal services are provided by Peter Evans & Associates.