FDA Adverse Event Death Summary report: N

SETROX S 53

MDR report key: 2072494 · Received April 22, 2011

Report

Report Number
1028232-2011-00906
Event Type
Death
Date Received
April 22, 2011
Date of Event
March 13, 2011
Report Date
April 12, 2011
Manufacturer
BIOTRONIK SE & CO. KG
Product Code
NVZ
PMA / PMN Number
P950037
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

THIS PATIENT EXPIRED AROUND (B)(6) 2011; THE EXACT DATE OF DEATH IS UNKNOWN. PER THE PRIMARY CARE PHYSICIAN'S OFFICE, THIS PATIENT EXPIRED DUE TO CARDIAC ARREST.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SETROX S 53 PACER LEAD NVZ BIOTRONIK SE & CO. KG 350974

Patients

Seq Age Sex Outcome Treatment
1 73 YR Death