BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ENTRUST AT

    MDR report key: 1013549 · Received March 10, 2008

    Report

    Report Number
    6000144-2008-00039
    Event Type
    Injury
    Date Received
    March 10, 2008
    Date of Event
    February 5, 2007
    Manufacturer
    MEDTRONIC MED REL, INC.
    Product Code
    LWS
    Removal / Correction Number
    NI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    LA
    Reporter Occupation
    INVALID DATA

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ENTRUST AT IMPLANTABLE PACEMAKER/CARDIO/DEFIB LWS MEDTRONIC MED REL, INC. D154ATG NA

    Patients

    Seq Age Sex Outcome Treatment
    1 49 YR Other 6949 IMPLANTABLE TACHY LEAD| 4076 IMPLANTABLE PACING LEAD