FDA Adverse Event Malfunction Summary report: N

CARELINK PROGRAM W/TELEMETRY C

MDR report key: 2201346 · Received August 11, 2011

Report

Report Number
2182208-2011-01182
Event Type
Malfunction
Date Received
August 11, 2011
Date of Event
May 6, 2011
Manufacturer
MEDTRONIC, INC.
Product Code
DXY
PMA / PMN Number
P890003/S080
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 WOULD NOT FULLY BOOT THE MAIN SCREEN. A SERVICE DISKETTE WAS REQUESTED TO CLEAR THE ERROR. IF THE ISSUE PERSISTS THE PROGRAMMER WILL BE RETURNED FOR REPAIR. NO PATIENT INVOLVEMENT OR COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CARELINK PROGRAM W/TELEMETRY C PROGRAMMER DXY MEDTRONIC, INC. 2090W ASKU

Patients

Seq Age Sex Outcome Treatment
1 Other