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 |