FDA Adverse Event Malfunction Summary report: N

ENRHYTHM DR

MDR report key: 1992541 · Received February 15, 2011

Report

Report Number
6000094-2011-00326
Event Type
Malfunction
Date Received
February 15, 2011
Manufacturer
MEDTRONIC S.A.
Product Code
DXY
PMA / PMN Number
P980035/S38
Removal / Correction Number
ASKU
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NL
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.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE HAD A POWER ON RESET. THE DEVICE REMAINS IN USE. 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 S.A. P1501DR ASKU

Patients

Seq Age Sex Outcome Treatment
1 Other