FDA Adverse Event Malfunction Summary report: N

CARELINK

MDR report key: 2202916 · Received August 11, 2011

Report

Report Number
3004593495-2011-00048
Event Type
Malfunction
Date Received
August 11, 2011
Date of Event
May 5, 2011
Manufacturer
PLEXUS MANUFACTURING SDN. BHD.
Product Code
NVZ
PMA / PMN Number
P890003/S154
Removal / Correction Number
ASKU
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS EVENT OCCURRED OUTSIDE THE US. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. PATIENT INFORMATION IS NOT GENERALLY AVAILABLE DUE TO CONFIDENTIALITY CONCERNS.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT SAW THE POWER LIGHT ON THE CARELINK MONITOR (CLM) WAS AMBER COLORED ON TWO OCCASIONS RATHER THAN GREEN. THE CLM REMAINS IN USE. 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 PATIENT MONITORING INSTRUMENT NVZ PLEXUS MANUFACTURING SDN. BHD. 2490C8 ASKU

Patients

Seq Age Sex Outcome Treatment
1 Other (B)(4) IMPLANTABLE PACEMAKER/CARDIO/DEFIB