BEUDAMED
    FDA Adverse Event Death Summary report: N

    ENTERRA

    MDR report key: 1071650 · Received July 9, 2008

    Report

    Report Number
    3004209178-2008-03860
    Event Type
    Death
    Date Received
    July 9, 2008
    Date of Event
    May 1, 2008
    Report Date
    May 9, 2008
    Manufacturer
    MEDTRONIC PUERTO RICO OPERATIONS CO.
    Product Code
    LNQ
    PMA / PMN Number
    HDE99015
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE PT EXPIRED. CAUSE OF DEATH COULD NOT BE OBTAINED BY THE TIME OF THIS REPORT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ENTERRA LNQ MEDTRONIC PUERTO RICO OPERATIONS CO. 3116 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 Death STIM ACCESSORY MODEL 4351 LOT# NHT006942N| EXPLANTED:| STIM ACCESSORY MODEL 4351 LOT# NHT006944N| IMPLANTED:| EXPLANTED:| IMPLANTED: