FDA Adverse Event Malfunction Summary report: N

PULSE-GENERATOR, DUAL CHAMBER, IMPLANTABLE

MDR report key: 2952693 · Received February 9, 2013

Report

Report Number
2183613-2013-00140
Event Type
Malfunction
Date Received
February 9, 2013
Date of Event
November 28, 2012
Report Date
November 28, 2012
Manufacturer
MEDTRONIC MILACA, INC.
Product Code
LWP
PMA / PMN Number
P820003
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

FURTHER REVIEW PROMPTED A CHANGE IN THE DEVICE ANALYSIS RESULTS. (B)(4).

Additional Manufacturer Narrative · 1

(B)(4) THIS EVENT OCCURRED OUTSIDE THE US WHERE THE SAME MODEL IS DISTRIBUTED. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. PATIENT INFORMATION IS NOT GENERALLY AVAILABLE DUE TO CONFIDENTIALITY CONCERNS.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE EXTERNAL PULSE GENERATOR (EPG) WOULD NOT POWER ON. THE ENGINEER FOUND BATTERY DEPLETION. THERE WAS NO PATIENT INVOLVEMENT INDICATED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE EXTERNAL PULSE GENERATOR (EPG) WOULD NOT POWER ON. THE ENGINEER FOUND BATTERY DEPLETION. THERE WAS NO PATIENT INVOLVEMENT INDICATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
56222 PULSE-GENERATOR, DUAL CHAMBER, IMPLANTABLE LWP MEDTRONIC MILACA, INC. 5348

Patients

Seq Age Sex Outcome Treatment
1