FDA Adverse Event Injury Summary report: N

KENTROX SL 65/16 STEROID

MDR report key: 1381858 · Received May 12, 2009

Report

Report Number
1028232-2009-00607
Event Type
Injury
Date Received
May 12, 2009
Date of Event
December 10, 2008
Report Date
April 21, 2009
Manufacturer
BIOTRONIK GMBH AND CO.
Product Code
LWS
PMA / PMN Number
P980023
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, 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

PER DEVICE TRACKING, THIS SYSTEM WAS REMOVED DUE TO INFECTION. LUMAX 340 DR-T, MDR 1028232-2009-00605. SELOX SR 45, MDR 1028232-2009-00606.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 KENTROX SL 65/16 STEROID ICD LEAD LWS BIOTRONIK GMBH AND CO. 347351

Patients

Seq Age Sex Outcome Treatment
1 82 YR Hospitalization