BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ENDOTAK DSP

    MDR report key: 2922878 · Received January 18, 2013

    Report

    Report Number
    2124215-2012-06876
    Event Type
    Injury
    Date Received
    January 18, 2013
    Date of Event
    May 2, 2012
    Report Date
    April 1, 2024
    Manufacturer
    BOSTON SCIENTIFIC CORPORATION
    Product Code
    LWS
    PMA / PMN Number
    P910073/S015
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL
    Health Professional
    Yes

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    28688 ENDOTAK DSP IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (NON-CRT) LWS BOSTON SCIENTIFIC CORPORATION 0095 200654

    Patients

    Seq Age Sex Outcome Treatment
    1 79 YR Male Life Threatening