FDA Adverse Event
Malfunction
Summary report: N
LINOX SD 65/16
MDR report key: 2891667
·
Received November 21, 2012
Report
- Report Number
- 1028232-2012-02940
- Event Type
- Malfunction
- Date Received
- November 21, 2012
- Date of Event
- October 8, 2012
- Report Date
- November 8, 2012
- Manufacturer
- BIOTRONIK SE & CO. KG
- Product Code
- LWS
- PMA / PMN Number
- P980023
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- OR, US
- Reporter Occupation
- NURSE
Narratives
Description of Event or Problem · 1
THERE WAS NOISE ON THE RV CHANNEL. THE PHYSICIAN ATTEMPTED TO EXTRACT THIS LEAD BUT WAS UNABLE TO REMOVE IT DUE TO STENOSIS. THE LEAD WAS CAPPED AND REPLACED. SHOULD ADD'L INFO BECOME AVAILABLE, THIS FILE WILL BE UPDATED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | LINOX SD 65/16 | ICD LEAD | LWS | BIOTRONIK SE & CO. KG | 350053 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 62 YR | Hospitalization |