BEUDAMED
    FDA Adverse Event Injury Summary report: N

    VENTAK PRX MODEL 1705

    MDR report key: 114716 · Received August 6, 1997

    Report

    Report Number
    114716
    Event Type
    Injury
    Date Received
    August 6, 1997
    Date of Event
    December 28, 1996
    Report Date
    December 28, 1996
    Manufacturer
    C.P.I.
    Product Code
    LWS
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    GENERATOR REPLACEMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VENTAK PRX MODEL 1705 Implant GENERATOR LWS C.P.I. 1705 *

    Patients

    Seq Age Sex Outcome Treatment
    1 70 YR Hospitalization| R