FDA Adverse Event Malfunction Summary report: N

ENRHYTHM DR

MDR report key: 1990091 · Received February 15, 2011

Report

Report Number
6000144-2011-00632
Event Type
Malfunction
Date Received
February 15, 2011
Manufacturer
MEDTRONIC MED REL, INC.
Product Code
DXY
PMA / PMN Number
P980035/S38
Removal / Correction Number
ASKU
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. EVALUATION SUMMARY: (B)(4): THE DEVICE WAS RETURNED, ANALYZED AND NO ANOMALIES WERE FOUND. IT WAS NOTED THAT THE LOW BATTERY VOLTAGE WAS A RESULT OF STORAGE TEMPERATURE. THE BATTERY VOLTAGE RECOVERED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE WAS STILL IN THE BOX AND TESTED WITH A LOW BATTERY VOLTAGE. THE DEVICE WAS SENT TO THE MANUFACTURER FOR ANALYSIS. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENRHYTHM DR IMPLANTABLE PULSE GENERATOR DXY MEDTRONIC MED REL, INC. P1501DR ASKU

Patients

Seq Age Sex Outcome Treatment
1 Other