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 |