BEUDAMED
    FDA Adverse Event Injury Summary report: N

    KAPPA DR 400

    MDR report key: 1031747 · Received April 15, 2008

    Report

    Report Number
    1031747
    Event Type
    Injury
    Date Received
    April 15, 2008
    Date of Event
    January 18, 2008
    Report Date
    April 14, 2008
    Manufacturer
    MEDTRONIC INC
    Product Code
    DXY
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    HI, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    EOL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KAPPA DR 400 GENERATOR DXY MEDTRONIC INC KDR 403 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 77 YR Hospitalization