FDA Adverse Event
Malfunction
Summary report: N
PERMANENT PACEMAKER ELECTRODE
MDR report key: 17521856
·
Received August 12, 2023
Report
- Report Number
- MW5128804
- Event Type
- Malfunction
- Date Received
- August 12, 2023
- Report Date
- February 2, 2012
- Manufacturer
- PACESETTER
- Product Code
- DTB
- Report Source
- Voluntary report
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 0
TECHNICAL SERVICES RECEIVED A CALL ON 01/04/2012 FROM SALES REP. THRESHOLD IS 2.8/0.7 FOR ACTIVE LEAD WHICH REP THOUGHT WAS 1226T. PATIENT HAD CHB AND THEY ARE TRYING TO DETERMINE WHETHER OR NOT TO CONTINUE USING THE EXISTING LEAD. THIS REPORT REFLECTS INFORMATION RECEIVED BY FDA IN THE FORM OF A NOTIFICATION PER 803.22 (B)(2).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 868962 | PERMANENT PACEMAKER ELECTRODE | PERMANENT PACEMAKER ELECTRODE | DTB | PACESETTER | 1226T |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Unknown |