FDA Adverse Event Malfunction Summary report: N

PROLIEVE THERMODILITATION SYSTEM

MDR report key: 2150332 · Received August 21, 2008

Report

Report Number
3005099803-2008-02152
Event Type
Malfunction
Date Received
August 21, 2008
Date of Event
March 24, 2008
Report Date
March 25, 2008
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
MEQ
PMA / PMN Number
P030006
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

COMPLAINT CONFIRMED UPON RETURN OF DEVICE. RF CONTROL BOARD FAULTY, THEREBY, PRODUCING LOW READINGS DURING BOOT SEQUENCE. THE MODULE WAS REPLACED AND THE CONSOLE PASSED ALL TESTING. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION ON (B)(6) 2008, THAT A PROLIEVE THERMODILITATION SYSTEM EXPERIENCED LOW RF POWER DURING TESTING. THERE WAS NO PT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROLIEVE THERMODILITATION SYSTEM MEQ BOSTON SCIENTIFIC CORPORATION M006880806R0 CEL3906C

Patients

Seq Age Sex Outcome Treatment
1