BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SELOX SR 45

    MDR report key: 1381860 · Received May 12, 2009

    Report

    Report Number
    1028232-2009-00606
    Event Type
    Injury
    Date Received
    May 12, 2009
    Date of Event
    December 10, 2008
    Report Date
    April 21, 2008
    Manufacturer
    BIOTRONIK GMBH AND CO.
    Product Code
    DTB
    PMA / PMN Number
    P950037
    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 REINVESTIGATED. 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. KENTROX SL 65/16 STEROID, MDR 1028232-2009-00607.

    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 82 YR Hospitalization