FDA Adverse Event Malfunction Summary report: N

CARELINK

MDR report key: 2790178 · Received October 15, 2012

Report

Report Number
2182208-2012-03429
Event Type
Malfunction
Date Received
October 15, 2012
Manufacturer
MEDTRONIC, INC.
Product Code
NVZ
PMA / PMN Number
P890003/S145
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT IS BASED SOLELY ON DEVICE RETURN AND ANALYSIS. NO INFORMATION TO SUGGEST A DEVICE-RELATED ADVERSE EVENT OR PRODUCT PROBLEM WAS RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. EVALUATION SUMMARY: (B)(4): ANALYSIS COULD NOT CONFIRM THE CRACKING SOUND, HOWEVER THE POWER SUPPLY HAD A BURNT SMELL, WHICH WAS LIKELY THE CAUSE OF THE CRACKING SOUND. IT WAS ALSO NOTED THAT THE LIGHT-EMITTING DIODE (LED) CONTROL OUTPUT WAS OUT OF SPECIFICATION.

Description of Event or Problem · 1

IT WAS REPORTED THAT A CRACKING SOUND WAS HEARD FROM THE BACK OF THE PROGRAMMER. THE PROGRAMMER WAS RETURNED FOR SERVICE. IT WAS ANALYZED AND TESTED OUT OF SPECIFICATION. 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 PROGRAMMER NVZ MEDTRONIC, INC. 2090X

Patients

Seq Age Sex Outcome Treatment
1 Other 2290 PACING SYSTEM ANALYZER