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