FDA Adverse Event Injury Summary report: N

CONTAK RENEWAL 3

MDR report key: 1042840 · Received May 8, 2008

Report

Report Number
2124215-2008-33814
Event Type
Injury
Date Received
May 8, 2008
Date of Event
February 25, 2008
Report Date
February 25, 2008
Manufacturer
CARDIAC PACEMAKERS, INC
Product Code
NIK
Removal / Correction Number
Z47/53-08
Adverse Event
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 H179 NA

Patients

Seq Age Sex Outcome Treatment
1 78 YR Required Intervention