FDA Adverse Event Injury Summary report: N

COGNIS

MDR report key: 2052829 · Received April 13, 2011

Report

Report Number
2124215-2011-03790
Event Type
Injury
Date Received
April 13, 2011
Date of Event
February 24, 2011
Report Date
February 24, 2011
Manufacturer
GUIDANT CRM CLONMEL IRELAND
Product Code
NIK
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

AS NO FURTHER INFORMATION REGARDING THIS REPORT IS EXPECTED, OUR INVESTIGATION IS COMPLETE. THIS INVESTIGATION WILL BE UPDATED SHOULD FURTHER INFORMATION BE PROVIDED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC RECEIVED INFORMATION THAT THIS DEVICE WAS PART OF A SYSTEM EXPLANT DUE TO INFECTION. THERE WAS NO REPORT OF ADVERSE PATIENT EFFECTS DUE TO THE EXPLANT PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COGNIS IMPLANTABLE CHF PULSE GENERATOR NIK GUIDANT CRM CLONMEL IRELAND P106

Patients

Seq Age Sex Outcome Treatment
1 Other| R