BEUDAMED
    FDA Adverse Event Death Summary report: N

    TARGET TIP

    MDR report key: 1071216 · Received June 27, 2008

    Report

    Report Number
    2649622-2008-03270
    Event Type
    Death
    Date Received
    June 27, 2008
    Date of Event
    June 22, 2000
    Manufacturer
    MEDTRONIC PUERTO RICO, INC.
    Product Code
    DTB
    Removal / Correction Number
    NI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    US
    Reporter Occupation
    INVALID DATA

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TARGET TIP IMPLANTABLE PACING LEAD DTB MEDTRONIC PUERTO RICO, INC. 4011 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 0 YR Other 7005C IMPLANTABLE PULSE GENERATOR