FDA Adverse Event Injury Summary report: N

SETROX S 53

MDR report key: 1092585 · Received August 1, 2008

Report

Report Number
1028232-2008-00807
Event Type
Injury
Date Received
August 1, 2008
Date of Event
May 30, 2008
Report Date
July 1, 2008
Manufacturer
BIOTRONIK GMBH AND CO.
Product Code
DTB
PMA / PMN Number
P950037
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
DE, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

PER MDRF FROM NED ORTH, THIS LEAD HAD DISLODGED, AND WAS SUCCESSFULLY REPOSITIONED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SETROX S 53 PACER LEAD DTB BIOTRONIK GMBH AND CO. 350974

Patients

Seq Age Sex Outcome Treatment
1 81 YR Hospitalization