FDA Adverse Event Injury Summary report: N

CAPSURE EPI

MDR report key: 1072566 · Received July 10, 2008

Report

Report Number
2182208-2008-00246
Event Type
Injury
Date Received
July 10, 2008
Date of Event
February 29, 2008
Manufacturer
MEDTRONIC, INC.
Product Code
DTB
Removal / Correction Number
NI
Report Source
Manufacturer report
Reporter Location
MO
Reporter Occupation
INVALID DATA

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CAPSURE EPI IMPLANTABLE PACING LEAD DTB MEDTRONIC, INC. 4968 NA

Patients

Seq Age Sex Outcome Treatment
1 22 YR Required Intervention 7288 IMPLANTABLE PACEMAKER/CARDIO/DEFIB| 4968 IMPLANTABLE PACING LEAD| 6721M IMPLANTABLE TACHY LEAD