FDA Adverse Event Injury Summary report: N

LINOX SD 65/16

MDR report key: 3083025 · Received April 29, 2013

Report

Report Number
1028232-2013-01158
Event Type
Injury
Date Received
April 29, 2013
Date of Event
April 12, 2013
Report Date
April 17, 2013
Manufacturer
BIOTRONIK SE & CO. KG
Product Code
NVY
PMA / PMN Number
P980023
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS NOT RETURNED FOR ANALYSIS. THEREFORE THE QUALITY DOCUMENTS ASSOCIATED WITH THE MANUFACTURE OF THIS PARTICULAR DEVICE WERE RE-INVESTIGATED. THERE WAS NO SIGN OF ANY INCONSISTENCY DURING PRODUCTION AND FINAL ACCEPTANCE TEST. THE BIOTRONIK STERILIZATION PROTOCOL CONFIRMED THAT ALL STERILIZATION PARAMETERS, SUCH AS GAS CONCENTRATION, TEMPERATURE, HUMIDITY, ETC., WERE IN THEIR SPECIFIED RANGES. ALSO, THE INVESTIGATION OF THE MICROBIOLOGICAL INDICATORS SHOWED THE SUCCESSFUL COMPLETION OF THE STERILIZATION PROCESS. IN SUMMARY, THE INFECTION WAS NOT DEVICE RELATED.

Description of Event or Problem · 1

THIS SYSTEM WAS REMOVED DUE TO SEPSIS. THERE IS NO INDICATION THAT THE SYSTEM WAS REPLACED. THE HOSPITAL RETAINED THE DEVICES. SHOULD ADDITIONAL INFORMATION BE RECEIVED, THIS FILE WILL BE UPDATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
183494 LINOX SD 65/16 ICD LEAD NVY BIOTRONIK SE & CO. KG 350053

Patients

Seq Age Sex Outcome Treatment
1 67 YR Hospitalization