BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MYOPORE® SUTURELESS MYOCARDIAL PACING LEAD

    MDR report key: 19780848 · Received July 19, 2024

    Report

    Report Number
    2183787-2024-00054
    Event Type
    Malfunction
    Date Received
    July 19, 2024
    Report Date
    June 24, 2024
    Manufacturer
    GREATBATCH MEDICAL
    Product Code
    DTB
    PMA / PMN Number
    P130012
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    US
    Reporter Occupation
    003

    Narratives

    Additional Manufacturer Narrative · 0

    UDI RELATED DATA QUALITY UPDATES ONLY. H2 CORRECTION WAS MARKED UDIS WERE NOT USED WHEN SKU 200988-XXX WAS MANUFACTURED. THE GTIN IN THE GUDID DATABASE WILL NOT ALIGN WITH THE BARCODE AS NEW GTINS WERE ASSIGNED WHEN GBM TRANSITIONED TO THE GUDID SYSTEM. CLASS III DEVICES WERE REQUIRED TO REGISTER GTINS IN THE GUDID DATABASE ON 01-JUN-2013; THEREFOR, THE UDI FIELD (D4) IN FORM 3500A SHALL BE LEFT BANK AND WILL NOT ALIGN WITH THE GUDID ENTRY DUE TO THE DATE IT WAS MANUFACTURED.

    Description of Event or Problem · 0

    LEAD WAS CAPPED DUE TO AN UNKNOWN REASON.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1645275 MYOPORE® SUTURELESS MYOCARDIAL PACING LEAD BIPOLAR EPICARDIAL LEAD DTB GREATBATCH MEDICAL 511212 W45012

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Male Required Intervention