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