BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    FINELINE II

    MDR report key: 1043556 · Received May 8, 2008

    Report

    Report Number
    2124215-2008-33077
    Event Type
    Malfunction
    Date Received
    May 8, 2008
    Date of Event
    February 1, 2008
    Report Date
    February 1, 2008
    Manufacturer
    CARDIAC PACEMAKERS, INC
    Product Code
    DTB
    Removal / Correction Number
    NA
    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 FINELINE II IMPLANTABLE LEAD DTB CARDIAC PACEMAKERS, INC 4470 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 20 YR Other THE DEVICE 0185/144358 WAS IMPLANTED 21-NOV-2007| THE DEVICE T180/ WAS IMPLANTED| THE DEVICE T180/213556 WAS IMPLANTED 21-NOV-2007