BEUDAMED
    FDA Adverse Event Injury Summary report: N

    QUICKSITE XL LV

    MDR report key: 1011149 · Received March 10, 2008

    Report

    Report Number
    2017865-2008-00650
    Event Type
    Injury
    Date Received
    March 10, 2008
    Date of Event
    October 17, 2007
    Report Date
    November 26, 2007
    Manufacturer
    ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
    Product Code
    DTB
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SC, US
    Reporter Occupation
    OTHER

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 QUICKSITE XL LV PERMANENT PACEMAKER ELECTRODE DTB ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 1058T/86 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 * Required Intervention