FDA Adverse Event Malfunction Summary report: N

PARADYM

MDR report key: 2182688 · Received July 8, 2011

Report

Report Number
1000165971-2011-00250
Event Type
Malfunction
Date Received
July 8, 2011
Date of Event
June 27, 2011
Report Date
July 1, 2011
Manufacturer
SORIN CRM S.R.L.
Product Code
MRM
PMA / PMN Number
P060027
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(6)., 2011. THIS EVENT CONCERNS A DEVICE THAT WAS MANUFACTURED AND USED OUTSIDE THE UNITED STATES. ANALYSIS IS PENDING.

Description of Event or Problem · 1

REPORTEDLY ON (B)(6) 2011 THE PHYSICIAN OBSERVED THAT A WARNING WAS DISPLAYED UPON INTERROGATION STATING THAT THE DEVICE WAS RE-INITIALIZED ON (B)(6) 2011. THE PHYSICIAN WANTS TO KNOW THE ROOT CAUSE OF THIS RE-INITIALIZATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PARADYM MRM SORIN CRM S.R.L. PARADYM CRT 8750 2433

Patients

Seq Age Sex Outcome Treatment
1