FDA Adverse Event
Injury
Summary report: N
LUMAX 540 HF-T
MDR report key: 2111779
·
Received May 25, 2011
Report
- Report Number
- 1028232-2011-01170
- Event Type
- Injury
- Date Received
- May 25, 2011
- Date of Event
- April 28, 2011
- Report Date
- May 18, 2011
- Manufacturer
- BIOTRONIK SE & CO. KG
- Product Code
- MRM
- PMA / PMN Number
- P050023
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- OR, US
- Reporter Occupation
- NURSE
Narratives
Description of Event or Problem · 1
THIS SYS WAS REMOVED DUE TO (B)(6) AND ALL AVAILABLE INFO SUGGESTS THAT THE SYS WAS NOT REPLACED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | LUMAX 540 HF-T | CRT-D | MRM | BIOTRONIK SE & CO. KG | 360347 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 78 YR | Hospitalization |