FDA Adverse Event Malfunction Summary report: N

SELOX SR 45

MDR report key: 1150125 · Received August 29, 2008

Report

Report Number
1028232-2008-01068
Event Type
Malfunction
Date Received
August 29, 2008
Date of Event
July 24, 2008
Report Date
August 4, 2008
Manufacturer
BIOTRONIK GMBH AND CO.
Product Code
DTB
PMA / PMN Number
P950037
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

PER OOS, THIS LEAD WAS REMOVED DUE TO CHRONIC HIGH THRESHOLDS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SELOX SR 45 PACER LEAD DTB BIOTRONIK GMBH AND CO. 343081

Patients

Seq Age Sex Outcome Treatment
1 69 YR Hospitalization