BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SETROX S 53

    MDR report key: 2942093 · Received December 27, 2012

    Report

    Report Number
    1028232-2012-03421
    Event Type
    Malfunction
    Date Received
    December 27, 2012
    Date of Event
    November 28, 2012
    Report Date
    December 13, 2012
    Manufacturer
    BIOTRONIK SE & CO. KG
    Product Code
    NVZ
    PMA / PMN Number
    P950037
    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 OF A FRACTURE. IMPEDANCE READINGS WERE GREATER THAN 3200 OHMS. THERE WERE NO ADVERSE PT EVENTS REPORTED. SHOULD ADD'L INFO BE RECEIVED, THIS FILE WILL BE UPDATED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SETROX S 53 PACER LEAD NVZ BIOTRONIK SE & CO. KG 350974

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR Hospitalization