FDA Adverse Event
Malfunction
Summary report: N
PERMANENT PACEMAKER ELECTRODE
MDR report key: 17524898
·
Received August 12, 2023
Report
- Report Number
- MW5131839
- 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 01/13/2012. CALLER STATED THAT THE OUTPUT WAS HIGH ON THIS RV LEAD. NO ADDITIONAL INFORMATION IS AVAILABLE AT THIS TIME. LEAD REMAINS IN SERVICE. 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 |
|---|---|---|---|---|---|---|---|
| 2117970 | PERMANENT PACEMAKER ELECTRODE | PERMANENT PACEMAKER ELECTRODE | DTB | PACESETTER | 1388TC |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Unknown |