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 |