BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    AT500

    MDR report key: 1013468 · Received March 10, 2008

    Report

    Report Number
    6000094-2008-00077
    Event Type
    Malfunction
    Date Received
    March 10, 2008
    Date of Event
    May 1, 2007
    Manufacturer
    MEDTRONIC S.A.
    Product Code
    DXY
    Removal / Correction Number
    NI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL
    Reporter Occupation
    INVALID DATA

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AT500 IMPLANTABLE PULSE GENERATOR DXY MEDTRONIC S.A. AT501 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 79 YR Other 5076 X2 IMPLANTABLE PACING LEAD