BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MERLIN PROGRAMMER

    MDR report key: 2905003 · Received January 9, 2013

    Report

    Report Number
    2017865-2013-00789
    Event Type
    Malfunction
    Date Received
    January 9, 2013
    Date of Event
    October 12, 2012
    Manufacturer
    ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
    Product Code
    KRG
    PMA / PMN Number
    P030054
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED. (B)(4).

    Description of Event or Problem · 1

    IT WAS REPORTED THAT SMOKE WAS NOTED COMING OUT OF THE PROGRAMMER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    12501 MERLIN PROGRAMMER PACEMAKER PROGRAMMER KRG ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 3650 NA

    Patients

    Seq Age Sex Outcome Treatment
    1