FDA Adverse Event Malfunction Summary report: N

LINOX S 75

MDR report key: 2942092 · Received December 27, 2012

Report

Report Number
1028232-2012-03375
Event Type
Malfunction
Date Received
December 27, 2012
Date of Event
November 19, 2012
Report Date
December 10, 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

THIS LEAD WAS CAPPED AND REPLACED BECAUSE IT WAS NOT "SENSING APPROPRIATELY" AND HAD LOSS OF CAPTURE. SHOULD ADD'L INFO BECOME AVAILABLE, THIS FILE WILL BE UPDATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LINOX S 75 ICD LEAD LWS BIOTRONIK SE & CO. KG 351334

Patients

Seq Age Sex Outcome Treatment
1 67 YR Hospitalization