BEUDAMED
    FDA Adverse Event Injury Summary report: N

    INSYNC III

    MDR report key: 1072436 · Received July 10, 2008

    Report

    Report Number
    6000094-2008-00288
    Event Type
    Injury
    Date Received
    July 10, 2008
    Date of Event
    September 18, 2007
    Manufacturer
    MEDTRONIC S.A.
    Product Code
    DXY
    Removal / Correction Number
    NI
    Report Source
    Manufacturer report
    Reporter Location
    RI
    Reporter Occupation
    INVALID DATA

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 INSYNC III IMPLANTABLE PULSE GENERATOR DXY MEDTRONIC S.A. 8042 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 70 YR Other 4194 IMPLANTABLE PACING LEAD| 5076 X 2 IMPLANTABLE PACING LEADS