FDA Adverse Event Malfunction Summary report: N

CARELINK

MDR report key: 3151529 · Received June 7, 2013

Report

Report Number
2182208-2013-01158
Event Type
Malfunction
Date Received
June 7, 2013
Date of Event
March 4, 2013
Report Date
March 4, 2013
Manufacturer
RICE CREEK MFG
Product Code
DXY
PMA / PMN Number
P890003
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PRODUCT EVENT SUMMARY: THE PROGRAMMER WAS RETURNED AND ANALYSIS CONFIRMED THE CUSTOMER COMMENT THAT IT BOOTED TO AN ERROR. THE MICRO PROCESSOR UNIT (MPU) BOARD WAS REPLACED, THE HARD DRIVE REIMAGED AND THE SOFTWARE RELOADED. ANALYSIS ALSO FOUND THAT THE MEDIA BAY DOOR LATCH WAS MISSING. THE MEDIA BAY DOOR WAS REPLACED. (B)(4).

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. (B)(4).

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 1

IT WAS REPORTED THE PROGRAMMER WILL NOT BOOT UP. IT GIVES AN ERROR CODE. THE PROGRAMMER WAS RETURNED FOR REPAIR. NO PATIENT COMPLICATIONS WERE REPORTED AS A RESULT OF THIS EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THE PROGRAMMER WILL NOT BOOT UP. IT GIVES AN ERROR CODE. THE PROGRAMMER WAS RETURNED FOR REPAIR. NO PATIENT COMPLICATIONS WERE REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
253378 CARELINK PULSE-GENERATOR, PACEMAKER, IMPLANTABLE DXY RICE CREEK MFG 2090

Patients

Seq Age Sex Outcome Treatment
1