FDA Adverse Event
Malfunction
Summary report: N
ENDOTAK RELIANCE
MDR report key: 1042777
·
Received May 8, 2008
Report
- Report Number
- 2124215-2008-33864
- Event Type
- Malfunction
- Date Received
- May 8, 2008
- Date of Event
- February 26, 2008
- Report Date
- February 26, 2008
- Manufacturer
- CARDIAC PACEMAKERS, INC
- Product Code
- DTB
- Removal / Correction Number
- NA
- Report Source
- Manufacturer report
- Reporter Location
- FR
- Reporter Occupation
- LAY USER/PATIENT
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | ENDOTAK RELIANCE | IMPLANTABLE LEAD | DTB | CARDIAC PACEMAKERS, INC | 0148 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other | THE DEVICE 0184/ WAS IMPLANTED| THE DEVICE 1861/ WAS IMPLANTED| THE DEVICE 1861/245269 WAS IMPLANTED |