FDA Adverse Event Malfunction Summary report: N

DEEP BRAIN STIMULATION LEAD

MDR report key: 2241043 · Received August 17, 2011

Report

Report Number
6000153-2011-06487
Event Type
Malfunction
Date Received
August 17, 2011
Date of Event
July 27, 2011
Report Date
July 27, 2011
Manufacturer
MPROC, VILLALBA
Product Code
MHY
PMA / PMN Number
P960009
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT WHEN THE HCP OPENED THE LEAD HE NOTICED THAT THE DISTAL TIP WAS SLIGHTLY BENT. THE LEAD WAS ALSO REPORTEDLY SOMEWHAT THICKER THAN NORMAL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DEEP BRAIN STIMULATION LEAD MHY MPROC, VILLALBA 3389 V728909

Patients

Seq Age Sex Outcome Treatment
1