BEUDAMED
    FDA Adverse Event Injury Summary report: N

    KAPPA 700 SR

    MDR report key: 1072840 · Received July 10, 2008

    Report

    Report Number
    2647346-2008-00301
    Event Type
    Injury
    Date Received
    July 10, 2008
    Date of Event
    July 5, 2007
    Manufacturer
    MEDTRONIC MED REL, INC.
    Product Code
    DXY
    Removal / Correction Number
    NI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    ME
    Reporter Occupation
    INVALID DATA

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KAPPA 700 SR IMPLANTABLE PULSE GENERATOR DXY MEDTRONIC MED REL, INC. KSR701 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 19 YR Other 4269 NON-MEDTRONIC IMPLANTABLE PACING LEAD