FDA Adverse Event
Malfunction
Summary report: N
FLEXTEND 2
MDR report key: 1041485
·
Received May 8, 2008
Report
- Report Number
- 2124215-2008-32041
- Event Type
- Malfunction
- Date Received
- May 8, 2008
- Date of Event
- December 13, 2007
- Report Date
- February 8, 2008
- Manufacturer
- CARDIAC PACEMAKERS, INC
- Product Code
- DTB
- Removal / Correction Number
- NA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- GM
- Reporter Occupation
- PHYSICIAN
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | FLEXTEND 2 | IMPLANTABLE LEAD | DTB | CARDIAC PACEMAKERS, INC | 4097 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 50 YR | Other | THE DEVICE T167/105008 WAS IMPLANTED 09-JAN-2006| THE DEVICE 0185/129552 WAS IMPLANTED 09-JAN-2006 |