BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    LUMAX 540 VR-T

    MDR report key: 2882174 · Received November 13, 2012

    Report

    Report Number
    1028232-2012-02785
    Event Type
    Malfunction
    Date Received
    November 13, 2012
    Date of Event
    July 30, 2012
    Report Date
    October 31, 2012
    Manufacturer
    BIOTRONIK SE & CO. KG
    Product Code
    MRM
    PMA / PMN Number
    P980023
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GM
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4) MDR.

    Description of Event or Problem · 1

    (B)(4) MDR- AFTER AN IMPLANTATION PERIOD OF ABOUT 24 MONTHS, OVERSENSING WAS REPORTED. NO ADVERSE PATIENT SIDE EFFECTS HAVE BEEN REPORTED. THE DEVICE WAS EXPLANTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LUMAX 540 VR-T ICD MRM BIOTRONIK SE & CO. KG 360348

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK Hospitalization