FDA Adverse Event Injury Summary report: N

MERIDIAN DDD

MDR report key: 1043334 · Received May 8, 2008

Report

Report Number
2124215-2008-33303
Event Type
Injury
Date Received
May 8, 2008
Date of Event
February 8, 2008
Report Date
February 8, 2008
Manufacturer
CARDIAC PACEMAKERS, INC
Product Code
DXY
Removal / Correction Number
Z1032-39/5
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 MERIDIAN DDD IMPLANTABLE PULSE GENERATOR DXY CARDIAC PACEMAKERS, INC 0976 NA

Patients

Seq Age Sex Outcome Treatment
1 77 YR Required Intervention THE DEVICE 4456/300068 WAS IMPLANTED 02-JUL-2001| THE DEVICE 4016/BIQ109 WAS IMPLANTED 19-MAY-2000| THE DEVICE 4034/215586 WAS IMPLANTED 19-MAY-2000| THE DEVICE 4063/302450 WAS IMPLANTED 02-JUL-2001| THE DEVICE 1290/763458 WAS IMPLANTED 28-FEB-2007| THE DEVICE 1280/508612 WAS IMPLANTED 02-JUL-2001