BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MERIDIAN SR

    MDR report key: 1041637 · Received May 8, 2008

    Report

    Report Number
    2124215-2008-35007
    Event Type
    Injury
    Date Received
    May 8, 2008
    Date of Event
    January 26, 2008
    Report Date
    February 1, 2008
    Manufacturer
    CARDIAC PACEMAKERS, INC
    Product Code
    DXY
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SF
    Reporter Occupation
    PHYSICIAN

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MERIDIAN SR IMPLANTABLE PULSE GENERATOR DXY CARDIAC PACEMAKERS, INC 1176 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 60 YR Required Intervention THE DEVICE 4035/318656 WAS IMPLANTED 13-JAN-2003