BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ACTIVE FIXATION LEAD

    MDR report key: 1011069 · Received March 10, 2008

    Report

    Report Number
    2017865-2008-00750
    Event Type
    Malfunction
    Date Received
    March 10, 2008
    Date of Event
    December 1, 2007
    Manufacturer
    ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
    Product Code
    DTB
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MA, US
    Reporter Occupation
    PHYSICIAN

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ACTIVE FIXATION LEAD PERMANENT PACEMAKER ELECTRODE DTB ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 1148T/52 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 *