FDA Adverse Event Malfunction Summary report: N

PACEART SYSTEM

MDR report key: 2130784 · Received June 16, 2011

Report

Report Number
2182208-2011-00875
Event Type
Malfunction
Date Received
June 16, 2011
Date of Event
April 19, 2011
Manufacturer
MEDTRONIC, INC.
Product Code
DPS
PMA / PMN Number
K024278
Removal / Correction Number
ASKU
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
HEALTH PROFESSIONAL

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.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE CLIENT WAS UNABLE TO OPEN THE CARELINK WEBSITE. A BLANK SCREEN WOULD APPEAR AND THE WEBSITE WOULD NOT APPEAR. FOLLOW-UP CONCLUDED THAT ISSUE CLEARED ON ITS OWN. NO PATIENT INVOLVEMENT OR COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PACEART SYSTEM SOFTWARE DPS MEDTRONIC, INC. GCII ASKU

Patients

Seq Age Sex Outcome Treatment
1 Other