BEUDAMED
    FDA Adverse Event Death Summary report: N

    TARGET TIP

    MDR report key: 1041090 · Received May 12, 2008

    Report

    Report Number
    2649622-2008-03195
    Event Type
    Death
    Date Received
    May 12, 2008
    Manufacturer
    MEDTRONIC PUERTO RICO, INC.
    Product Code
    DTB
    Removal / Correction Number
    M-002-2
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    US
    Reporter Occupation
    UNKNOWN

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TARGET TIP IMPLANTABLE PACING LEAD DTB MEDTRONIC PUERTO RICO, INC. 4012 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 69 YR Other 8160B IMPLANTABLE PULSE GENERATOR