BEUDAMED
    FDA Adverse Event Injury Summary report: N

    2649622-1998-00625

    MDR report key: 1992599 · Received February 15, 2011

    Report

    Report Number
    2649622-1998-00625
    Event Type
    Injury
    Date Received
    February 15, 2011
    Date of Event
    September 30, 1998
    Report Date
    June 10, 2019
    Manufacturer
    MPRI
    PMA / PMN Number
    ASKU
    Removal / Correction Number
    ASKU
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    PHYSICIAN
    Health Professional
    Yes

    Patients

    Seq Age Sex Outcome Treatment
    1 79 YR Male Required Intervention| H| O 5524M IMPLANTABLE PACING LEAD| 7086 IMPLANTABLE PULSE GENERATOR