FDA Adverse Event Malfunction Summary report: N

BRAVO

MDR report key: 1003427 · Received February 21, 2008

Report

Report Number
2032545-2008-00825
Event Type
Malfunction
Date Received
February 21, 2008
Report Date
January 21, 2008
Manufacturer
ARIZONA DEVICE MANUFACTURING
Product Code
FFT
PMA / PMN Number
K002028
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

FINAL DEVICE ANALYSIS WAS NOT AVAILABLE AT TIME OF THIS REPORT. A FOLLOW-UP MEDWATCH REPORT WILL BE SENT WHEN THE ANALYSIS IS COMPLETE AND/OR WHEN ADDITIONAL INFO IS RECEIVED FROM THE HCP.

Description of Event or Problem · 1

THE HCP REPORTED THAT WHILE PLACING A BRAVO PH MONITOR THE CAPSULE WOULD NOT DEPLOY FROM THE DELIVERY SYSTEM. NO SERIOUS INJURY TO THE PT WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BRAVO FFT ARIZONA DEVICE MANUFACTURING 9012B1001 Q212963

Patients

Seq Age Sex Outcome Treatment
1