FDA Adverse Event
Injury
Summary report: N
DEXTRUS 4135
MDR report key: 1033731
·
Received April 25, 2008
Report
- Report Number
- 1028232-2008-00436
- Event Type
- Injury
- Date Received
- April 25, 2008
- Date of Event
- February 18, 2008
- Report Date
- March 27, 2008
- Manufacturer
- BIOTRONIK GMBH AND CO.
- Product Code
- DTB
- PMA / PMN Number
- P950037
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- GM
- Reporter Occupation
- NOT APPLICABLE
Narratives
Description of Event or Problem · 1
BOSTON SCIENTIFIC CRM RECEIVED INFO THAT THIS RIGHT ATRIAL LEAD HAD DISLODGED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | DEXTRUS 4135 | PACER LEADS | DTB | BIOTRONIK GMBH AND CO. | 358744 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNK | Hospitalization |