BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    KAPPA 700 SR

    MDR report key: 1072812 · Received July 10, 2008

    Report

    Report Number
    6000094-2008-00319
    Event Type
    Malfunction
    Date Received
    July 10, 2008
    Date of Event
    April 23, 2008
    Manufacturer
    MEDTRONIC S.A.
    Product Code
    DXY
    Removal / Correction Number
    NI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IT
    Reporter Occupation
    PHYSICIAN

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KAPPA 700 SR IMPLANTABLE PULSE GENERATOR DXY MEDTRONIC S.A. KSR701 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 87 YR Required Intervention