BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ENDOTAK RELIANCE SG

    MDR report key: 3040912 · Received April 8, 2013

    Report

    Report Number
    2124215-2013-03738
    Event Type
    Injury
    Date Received
    April 8, 2013
    Date of Event
    February 20, 2013
    Report Date
    February 29, 2024
    Manufacturer
    BOSTON SCIENTIFIC CORPORATION
    Product Code
    LWS
    PMA / PMN Number
    P910073/S043
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UK
    Reporter Occupation
    003

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    144296 ENDOTAK RELIANCE SG IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (NON-CRT) LWS BOSTON SCIENTIFIC CORPORATION 0181 305397

    Patients

    Seq Age Sex Outcome Treatment
    1 69 YR Male Required Intervention| H| L