FDA Adverse Event Malfunction Summary report: N

PHILOS II DR

MDR report key: 1082442 · Received July 21, 2008

Report

Report Number
1028232-2008-00761
Event Type
Malfunction
Date Received
July 21, 2008
Date of Event
June 6, 2008
Report Date
June 23, 2008
Manufacturer
BIOTRONIK GMBH AND CO.
Product Code
DXY
PMA / PMN Number
P950037
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

THIS DEVICE WAS RETURNED WITH DOCUMENTATION FROM BIOTRONIK REPRESENTATIVE. THIS DEVICE COULD NOT BE INTERROGATED. THIS DEVICE WAS REPLACED WITH ANOTHER PHILOS II DR. THERE ARE NO ADVERSE EVENTS REPORTED FOR THIS PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PHILOS II DR PACEMAKER DXY BIOTRONIK GMBH AND CO. 341826

Patients

Seq Age Sex Outcome Treatment
1 83 YR Hospitalization