BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ATTAIN

    MDR report key: 1854935 · Received October 5, 2010

    Report

    Report Number
    2182208-2010-00654
    Event Type
    Malfunction
    Date Received
    October 5, 2010
    Date of Event
    June 12, 2010
    Manufacturer
    MEDTRONIC, INC.
    Product Code
    DYG
    PMA / PMN Number
    K012225
    Removal / Correction Number
    ASKU
    Report Source
    Manufacturer report
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    THIS EVENT OCCURRED OUTSIDE THE US. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. PATIENT INFORMATION IS NOT GENERALLY AVAILABLE DUE TO CONFIDENTIALITY CONCERNS. EVALUATION SUMMARY: (B)(4) NO ANOMALIES WERE FOUND.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE PRODUCT COULD NOT BE USED IN THE PATIENT'S BODY BECAUSE THE ARTERY WAS TOO NARROW. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ATTAIN LEFT HEART DELIVERY SYSTEM DYG MEDTRONIC, INC. 6215 ASKU

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR Other