FDA Adverse Event Injury Summary report: N

CONTAK RENEWAL 3

MDR report key: 1041459 · Received May 8, 2008

Report

Report Number
2124215-2008-32071
Event Type
Injury
Date Received
May 8, 2008
Date of Event
January 2, 2008
Report Date
January 2, 2008
Manufacturer
CARDIAC PACEMAKERS, INC
Product Code
NIK
Removal / Correction Number
Z47/55-07
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CONTAK RENEWAL 3 IMPLANTABLE CHF GENERATOR NIK CARDIAC PACEMAKERS, INC H170 NA

Patients

Seq Age Sex Outcome Treatment
1 77 YR Required Intervention THE DEVICE 4543/114771 WAS IMPLANTED 14-APR-2006| THE DEVICE 0184/122753 WAS IMPLANTED 14-APR-2006