FDA Adverse Event Injury Summary report: N

LUMAX 340 VR-T

MDR report key: 1211785 · Received October 24, 2008

Report

Report Number
1028232-2008-01300
Event Type
Injury
Date Received
October 24, 2008
Date of Event
November 15, 2007
Manufacturer
BIOTRONIK GMBH AND CO.
Product Code
LWS
PMA / PMN Number
P980023
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
KY, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

(SEE SCANNED PAGE).

Description of Event or Problem · 1

PER STUDY ADVERSE EVENT FORM, THIS PATIENT WAS GIVEN ANTIBIOTICS FOR AN INFECTION. THE SYSTEM WAS NOT REMOVED. SYSTEM BEING REPORTED: LUMAX 340 VR-T, MDR 1028232-2008-01300. LINOX SD 65/18, MDR 1028232-2008-01301.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LUMAX 340 VR-T ICD LWS BIOTRONIK GMBH AND CO. 355271

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention