FDA Adverse Event Malfunction Summary report: N

CARELINK

MDR report key: 2201338 · Received August 11, 2011

Report

Report Number
2182208-2011-01184
Event Type
Malfunction
Date Received
August 11, 2011
Date of Event
May 6, 2011
Manufacturer
MEDTRONIC, INC.
Product Code
KRG
PMA / PMN Number
P890003/S065
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.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PROGRAMMER EXPERIENCED AN ERROR. A SERVICE DISKETTE WAS REQUESTED TO CLEAR THE ERROR. NO PATIENT INVOLVEMENT OR COMPLICATIONS WERE REPORTED.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 Other