FDA Adverse Event Injury Summary report: N

ENRHYTHM DR

MDR report key: 2791678 · Received October 15, 2012

Report

Report Number
6000094-2012-02293
Event Type
Injury
Date Received
October 15, 2012
Date of Event
August 14, 2012
Manufacturer
MEDTRONIC S.A.
Product Code
DXY
PMA / PMN Number
P980035/S38
Removal / Correction Number
Z-1440-2010
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GB
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS EVENT OCCURRED OUTSIDE THE US. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. PATIENT INFORMATION IS NOT GENERALLY AVAILABLE DUE TO CONFIDENTIALITY CONCERNS. EVALUATION SUMMARY (B)(4): THE ACTUAL DEVICE WAS NOT RECEIVED FOR EVALUATION. WE DID RECEIVE PERFORMANCE DATA COLLECTED FROM THE DEVICE AND HAVE ANALYZED THE DATA. POWER ON RESET - POWER ON RESET PARAMETERS. THE DEVICE EXPERIENCED A CRITICAL RAM PARITY ERROR POR ON 15 MAY 2012 IN LOCATION "0F 85." DEVICE SHOULD BE ABLE TO RECOVER FROM THE EVENT AND CONTINUE NORMAL FUNCTION.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE WARNED THERE WAS AN ELECTRICAL RESET. THE DEVICE WAS INTERROGATED AND THE RESET WAS CLEARED. THE DEVICE REMAINS IN USE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENRHYTHM DR IMPLANTABLE PULSE GENERATOR DXY MEDTRONIC S.A. P1501DR

Patients

Seq Age Sex Outcome Treatment
1 86 YR Required Intervention