FDA Adverse Event Injury Summary report: N

LINOX SD 65/16

MDR report key: 1379289 · Received May 6, 2009

Report

Report Number
1028232-2009-00581
Event Type
Injury
Date Received
May 6, 2009
Date of Event
January 24, 2009
Report Date
April 8, 2009
Manufacturer
BIOTRONIK GMBH AND CO.
Product Code
LWS
PMA / PMN Number
P950037
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS NOT RETURNED FOR ANALYSIS. THEREFORE, THE QUALITY DOCUMENTS ACCOMPANYING THIS PARTICULAR DEVICE WERE RE-INVESTIGATED. THERE WAS NO SIGN OF ANY INCONSISTENCY DURING PRODUCTION AND FINAL ACCEPTANCE TEST. THE BIOTRONIK STERILIZATION PROTOCOL CONFIRMED THAT ALL STERILIZATION PARAMETERS, SUCH AS GAS CONCENTRATION, TEMPERATURE, HUMIDITY, ETC., WERE IN THEIR SPECIFIED RANGES. ALSO, THE INVESTIGATION OF THE MICROBIOLOGICAL INDICATORS SHOWED THE SUCCESSFUL COMPLETION OF THE STERILIZATION PROCESS. IN SUMMARY, THE INFECTION WAS NOT DEVICE RELATED.

Description of Event or Problem · 1

THIS SYSTEM WAS REMOVED DUE TO INFECTION. THIS SYSTEM HAS NOT BEEN REPLACED. LUMAX 340 DR-T, MDR 1028232-2009-00579. SELOX JT 45, MDR 1028232-2009-00580.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LINOX SD 65/16 ICD LEAD LWS BIOTRONIK GMBH AND CO. 350053

Patients

Seq Age Sex Outcome Treatment
1 49 YR Hospitalization