BEUDAMED
    FDA Adverse Event Death Summary report: N

    MEDTRONIC PACING

    MDR report key: 252195 · Received November 19, 1999

    Report

    Report Number
    252195
    Event Type
    Death
    Date Received
    November 19, 1999
    Date of Event
    November 9, 1999
    Report Date
    November 18, 1999
    Manufacturer
    MEDTRONIC PACING PRODUCTS
    Product Code
    DXY
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    PA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    THE PT, ON ARRIVAL TO HOSP, HAD A JUNCTIONAL ESCAPE RHYTHM IN THE LOW 30'S WITH NONCAPTURE OF THE PACEMAKER "ARTIFACTS." FAMILY DECLINED PACEMAKER REPLACEMENT AND PT EXPIRED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDTRONIC PACING Implant MULTIPROGRAMABLE PULSE GENERATOR DXY MEDTRONIC PACING PRODUCTS NX2005398H *

    Patients

    Seq Age Sex Outcome Treatment
    1 89 YR Death