FDA Adverse Event
Injury
Summary report: N
ACCUFIX
MDR report key: 168881
·
Received May 20, 1998
Report
- Report Number
- 1723248-1998-00251
- Event Type
- Injury
- Date Received
- May 20, 1998
- Date of Event
- February 5, 1998
- Report Date
- May 19, 1998
- Manufacturer
- TELECTRONICS PACING SYSTEMS
- Product Code
- DTB
- Removal / Correction Number
- Z-209/211/5
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MI, US
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
VISUAL INSPECTION UNDER 30X MAGNIFICATION INDICATES NO "J" WIRE DISCREPANCIES. X-RAY OF LEAD 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 | 74 YR | Required Intervention |