BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SELECT SECURE

    MDR report key: 1050063 · Received May 22, 2008

    Report

    Report Number
    2649622-2008-03237
    Event Type
    Injury
    Date Received
    May 22, 2008
    Date of Event
    April 2, 2008
    Manufacturer
    MEDTRONIC PUERTO RICO, INC.
    Product Code
    NVN
    Removal / Correction Number
    NI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN
    Reporter Occupation
    INVALID DATA

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SELECT SECURE IMPLANTABLE PACING LEAD NVN MEDTRONIC PUERTO RICO, INC. 3830 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 12 YR Required Intervention 1290 IMPLANTABLE PULSE GENERATOR| 4076 IMPLANTABLE PACING LEAD