FDA Adverse Event Injury Summary report: N

CONTAK RENEWAL 3 RF

MDR report key: 1043502 · Received May 8, 2008

Report

Report Number
2124215-2008-33135
Event Type
Injury
Date Received
May 8, 2008
Date of Event
January 31, 2008
Report Date
January 31, 2008
Manufacturer
CARDIAC PACEMAKERS, INC
Product Code
NIK
Removal / Correction Number
Z-0863-05
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CONTAK RENEWAL 3 RF IMPLANTABLE CHF GENERATOR NIK CARDIAC PACEMAKERS, INC H210 NA

Patients

Seq Age Sex Outcome Treatment
1 49 YR Required Intervention THE DEVICE 4591/000516 WAS IMPLANTED 11-MAY-2006| THE DEVICE 0180/102528 WAS IMPLANTED 05-JUN-2007