FDA Adverse Event
Malfunction
Summary report: N
LUMAX 540 DR-T
MDR report key: 2822084
·
Received October 9, 2012
Report
- Report Number
- 1028232-2012-02507
- Event Type
- Malfunction
- Date Received
- October 9, 2012
- Date of Event
- May 30, 2012
- Report Date
- September 27, 2012
- Manufacturer
- BIOTRONIK SE & CO. KG
- Product Code
- MRM
- PMA / PMN Number
- P000009
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- GM
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
OUS MDR.
Description of Event or Problem · 1
OUS MDR - OVERSENSING WAS REPORTED. NO ADVERSE PATIENT SIDE EFFECTS HAVE BEEN REPORTED. THE DEVICE WAS EXPLANTED. NO DATE OF IMPLANT WAS GIVEN.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | LUMAX 540 DR-T | ICD | MRM | BIOTRONIK SE & CO. KG | 360346 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNK | Hospitalization |