BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CONTAK RENEWAL 3

    MDR report key: 1042679 · Received May 8, 2008

    Report

    Report Number
    2124215-2008-33962
    Event Type
    Injury
    Date Received
    May 8, 2008
    Date of Event
    February 28, 2008
    Report Date
    February 28, 2008
    Manufacturer
    CARDIAC PACEMAKERS, INC
    Product Code
    NIK
    Removal / Correction Number
    Z47/55-07
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    LAY USER/PATIENT

    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 44 YR Required Intervention THE DEVICE 0184/127049 WAS IMPLANTED 23-AUG-2006| THE DEVICE 4473/440677 WAS IMPLANTED 23-AUG-2006| THE DEVICE 4548/152688 WAS IMPLANTED 23-AUG-2006