FDA Adverse Event Malfunction Summary report: N

FINELINE II

MDR report key: 1043565 · Received May 8, 2008

Report

Report Number
2124215-2008-33086
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 87 YR Other THE DEVICE 1290/788870 WAS IMPLANTED 17-JAN-2008| THE DEVICE 1294/960072 WAS IMPLANTED 28-JAN-2008