BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ACCUFIX

    MDR report key: 159765 · Received March 25, 1998

    Report

    Report Number
    1723248-1998-00155
    Event Type
    Injury
    Date Received
    March 25, 1998
    Date of Event
    February 12, 1998
    Report Date
    March 24, 1998
    Manufacturer
    TELECTRONICS PACING SYSTEMS
    Product Code
    DTB
    Removal / Correction Number
    Z-209/211/5
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    LEAD RECEIVED IN A PARTIAL DISTAL 26CM PORTION WITH NO "J" STIFFENER WIRE FRACTURES. X-RAY OF LEAD DISTALLY CONFIRMS NO "J" STIFFENER WIRE DISCREPANCIES.

    Description of Event or Problem · 1

    DEVICE ANALYSIS IS PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ACCUFIX Implant PERM IMPL PACER ELECTRODE DTB TELECTRONICS PACING SYSTEMS 330-801 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 78 YR Required Intervention