BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CAPSURE VDD

    MDR report key: 1072817 · Received July 10, 2008

    Report

    Report Number
    6000023-2008-00010
    Event Type
    Injury
    Date Received
    July 10, 2008
    Date of Event
    October 16, 2007
    Manufacturer
    MEDTRONIC, B.V.
    Product Code
    DTB
    Removal / Correction Number
    NI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OR
    Reporter Occupation
    INVALID DATA

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CAPSURE VDD IMPLANTABLE PACING LEAD DTB MEDTRONIC, B.V. 5032 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 59 YR Required Intervention 8968IB IMPLANTABLE PULSE GENERATOR