FDA Adverse Event
Injury
Summary report: N
3004209178-2011-02815
MDR report key: 2081041
·
Received April 14, 2011
Report
- Report Number
- 3004209178-2011-02815
- Event Type
- Injury
- Date Received
- April 14, 2011
- Manufacturer
- MEDTRONIC PUERTO RICO OPERATIONS CO., JUNCOS
- PMA / PMN Number
- P840001
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Occupation
- NOT APPLICABLE
- Health Professional
- N
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Female | Required Intervention | LEAD MODEL 39565-65 LOT# V362476011 IMPLANTED:1. |