FDA Adverse Event Malfunction Summary report: N

FINELINE II

MDR report key: 1042894 · Received May 8, 2008

Report

Report Number
2124215-2008-33757
Event Type
Malfunction
Date Received
May 8, 2008
Date of Event
February 15, 2008
Report Date
February 15, 2008
Manufacturer
CARDIAC PACEMAKERS, INC
Product Code
DTB
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
PHYSICIAN

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FINELINE II IMPLANTABLE LEAD DTB CARDIAC PACEMAKERS, INC 4473 NA

Patients

Seq Age Sex Outcome Treatment
1 76 YR Other THE DEVICE 0157/119653 WAS IMPLANTED 04-FEB-2004| THE DEVICE T125/103046 WAS IMPLANTED 04-FEB-2004| THE DEVICE T180/213913 WAS IMPLANTED 15-FEB-2008