FDA Adverse Event Malfunction Summary report: N

FINELINE II

MDR report key: 1042432 · Received May 8, 2008

Report

Report Number
2124215-2008-34219
Event Type
Malfunction
Date Received
May 8, 2008
Date of Event
March 7, 2008
Report Date
March 7, 2008
Manufacturer
CARDIAC PACEMAKERS, INC
Product Code
DTB
Removal / Correction Number
NA
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 FINELINE II IMPLANTABLE LEAD DTB CARDIAC PACEMAKERS, INC 4472 NA

Patients

Seq Age Sex Outcome Treatment
1 84 YR Other THE DEVICE 1290/705287 WAS IMPLANTED 24-DEC-2004| THE DEVICE 4087/227613 WAS IMPLANTED 24-DEC-2004