BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LINOX SD 65/16

    MDR report key: 1933014 · Received December 13, 2010

    Report

    Report Number
    1028232-2010-02731
    Event Type
    Injury
    Date Received
    December 13, 2010
    Date of Event
    November 19, 2010
    Report Date
    December 3, 2010
    Manufacturer
    BIOTRONIK SE & CO KG
    Product Code
    LWS
    PMA / PMN Number
    P980023
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OR, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    THIS LEAD BECAME DISLODGED AND WAS REPLACED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LINOX SD 65/16 ICD LEAD LWS BIOTRONIK SE & CO KG 350053

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR Hospitalization