BEUDAMED
    FDA Adverse Event Injury Summary report: N

    6000032-2011-06430

    MDR report key: 2332157 · Received November 10, 2011

    Report

    Report Number
    6000032-2011-06430
    Event Type
    Injury
    Date Received
    November 10, 2011
    Report Date
    November 1, 2024
    Manufacturer
    MDT PUERTO RICO OPERATIONS CO, MED REL
    PMA / PMN Number
    P840001
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    PHYSICIAN
    Health Professional
    Yes

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Male Required Intervention EXPLANTED| EXPLANTED| LEAD MODEL 3890 LOT# J0343741V IMPLANTED: | LEAD MODEL 3890 LOT# J0343742V, IMPLANTED