FDA Adverse Event Malfunction Summary report: N

CARELINK

MDR report key: 2130986 · Received June 16, 2011

Report

Report Number
2182208-2011-00880
Event Type
Malfunction
Date Received
June 16, 2011
Date of Event
April 25, 2011
Manufacturer
MEDTRONIC, INC.
Product Code
NVZ
PMA / PMN Number
P890003/S145
Removal / Correction Number
ASKU
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

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.

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. MODEL NUMBER WAS MADE TO REFLECT CORRECT MODEL AS 2090X.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PROGRAMMER INCURRED A SERIOUS ERROR WHEN BOOTING. A SERVICE DISK SENT TO CORRECT THE ISSUE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PROGRAMMER INCURRED A SERIOUS ERROR WHEN BOOTING. A SERVICE DISK SENT TO CORRECT THE ISSUE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CARELINK PROGRAMMER NVZ MEDTRONIC, INC. 2090X ASKU

Patients

Seq Age Sex Outcome Treatment
1 Other