BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TEMPO DR 2102 BI IS-1/VS-1

    MDR report key: 2240514 · Received September 9, 2011

    Report

    Report Number
    2017865-2011-05939
    Event Type
    Injury
    Date Received
    September 9, 2011
    Date of Event
    June 16, 2011
    Manufacturer
    ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
    Product Code
    MXC
    PMA / PMN Number
    NA
    Removal / Correction Number
    Z2733
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OR
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE IMPLANTABLE CARDIAC MONITOR (ICM) EXHIBITED PREMATURE BATTERY DEPLETION. THE DEVICE WAS REMOVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TEMPO DR 2102 BI IS-1/VS-1 LOOP RECORDER MXC ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION DM2102 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 58 YR Required Intervention