FDA Adverse Event Injury Summary report: N

COROX OTW 75-UP STEROID

MDR report key: 1231648 · Received November 14, 2008

Report

Report Number
1028232-2008-01475
Event Type
Injury
Date Received
November 14, 2008
Manufacturer
BIOTRONIK GMBH AND CO
Product Code
MRM
PMA / PMN Number
P050023
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

PER STUDY ADVERSE EVENT FORM, THIS LEAD CAUSED PHRENIC NERVE STIMULATION. THIS LEAD WAS ABANDONED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COROX OTW 75-UP STEROID LV LEAD MRM BIOTRONIK GMBH AND CO 346542

Patients

Seq Age Sex Outcome Treatment
1 79 YR Hospitalization