BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    UNKNOWN

    MDR report key: 17523776 · Received August 12, 2023

    Report

    Report Number
    MW5130724
    Event Type
    Malfunction
    Date Received
    August 12, 2023
    Date of Event
    September 2, 2011
    Report Date
    October 6, 2011
    Manufacturer
    MEDTRONIC
    Product Code
    DTB
    Report Source
    Voluntary report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 0

    LOW RIGHT VENTRICULAR PACING LEAD IMPEDANCE DETECTED ON (B)(6) 2011 04:06. NO PHYSICIAN OR HOSPITAL KNOWN. 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
    2234195 UNKNOWN PERMANENT PACEMAKER ELECTRODE DTB MEDTRONIC 6947

    Patients

    Seq Age Sex Outcome Treatment
    1 Unknown