BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    REPLY

    MDR report key: 2033836 · Received February 11, 2011

    Report

    Report Number
    1000165971-2011-00078
    Event Type
    Malfunction
    Date Received
    February 11, 2011
    Date of Event
    January 22, 2011
    Report Date
    February 1, 2011
    Manufacturer
    SORIN CRM S.R.L.
    Product Code
    NVZ
    PMA / PMN Number
    P950029
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4), 2011. THIS EVENT CONCERNS A DEVICE THAT WAS MANUFACTURED AND USED OUTSIDE THE UNITED STATES. ANALYSIS IS PENDING.

    Description of Event or Problem · 1

    REPORTEDLY ON (B)(6) 2011, THREE DAYS AFTER IMPLANTATION, THE PHYSICIAN NOTICED THAT AN ABNORMAL SHAPES WERE PRESENT ON THE VENTRICULAR CHANNEL ON THE EPISODE DATED (B)(6) 2011 ("NOISY" EPISODE). THE PHYSICIAN ASKED FOR AN EXPLANATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 REPLY NVZ SORIN CRM S.R.L. REPLY DR 2491

    Patients

    Seq Age Sex Outcome Treatment
    1