BEUDAMED
    FDA Adverse Event Death Summary report: N

    INSYNC II MARQUIS

    MDR report key: 1013397 · Received March 10, 2008

    Report

    Report Number
    6000094-2008-00082
    Event Type
    Death
    Date Received
    March 10, 2008
    Date of Event
    September 18, 2007
    Manufacturer
    MEDTRONIC S.A.
    Product Code
    NIK
    Removal / Correction Number
    NI
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    US
    Reporter Occupation
    ATTORNEY

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 INSYNC II MARQUIS IMPLANTABLE PACEMAKER/CARDIO/DEFIB NIK MEDTRONIC S.A. 7289 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 76 YR Death