FDA Adverse Event Malfunction Summary report: N

ENRHYTHM DR

MDR report key: 2130778 · Received June 16, 2011

Report

Report Number
6000144-2011-03402
Event Type
Malfunction
Date Received
June 16, 2011
Manufacturer
MEDTRONIC MED REL, INC.
Product Code
DXY
PMA / PMN Number
P980035/S38
Removal / Correction Number
Z-1440-2010
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. ANALYSIS OF THE DEVICE IS IN PROCESS; THE RESULTS WILL BE FORWARDED WHEN AVAILABLE.

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. EVALUATION SUMMARY FOR (B)(4): THE DEVICE WAS RETURNED, ANALYZED AND NO ANOMALIES WERE FOUND. LAB TESTING OF THE DEVICE COULD NOT CONFIRM THE REASON FOR RETURN. THE BATTERY VOLTAGE WAS NEVER AT ELECTIVE REPLACEMENT INDICATOR (ERI) DURING ALL LAB TESTS.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE FAILED FOR LOW BATTERY VOLTAGE WHILE STILL IN THE BOX. THERE WAS NO PATIENT INVOLVEMENT AND NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENRHYTHM DR IMPLANTABLE PULSE GENERATOR DXY MEDTRONIC MED REL, INC. P1501DR ASKU

Patients

Seq Age Sex Outcome Treatment
1 Other