FDA Adverse Event Death Summary report: N

ENRHYTHM

MDR report key: 2982191 · Received February 28, 2013

Report

Report Number
9614453-2013-00536
Event Type
Death
Date Received
February 28, 2013
Date of Event
April 30, 2012
Report Date
February 7, 2013
Manufacturer
IPG MFG SWITZERLAND
Product Code
NVZ
PMA / PMN Number
P980035
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
KU
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

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. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT, WHO WAS A PARTICIPANT IN THE (B)(4) STUDY, IS DECEASED. THE DEATH OCCURRED FIVE YEARS POST IMPLANT. THE CAUSE OF DEATH IS UNKNOWN. THE ADVERSE EVENT COMMITTEE OF THE STUDY CLASSIFIED THE RELATEDNESS OF THE ADVERSE EVENT TO THE PROCEDURE OR DEVICE AS "UNKNOWN" AND THE DEATH HAS BEEN CLASSIFIED AS "UNKNOWN".

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
87416 ENRHYTHM PULSE GENERATOR, PERMANENT, IMPLANTABLE NVZ IPG MFG SWITZERLAND P1501DR

Patients

Seq Age Sex Outcome Treatment
1 00064 YR Death