FDA Adverse Event Malfunction Summary report: N

CARELINK

MDR report key: 3152469 · Received June 7, 2013

Report

Report Number
2182208-2013-01552
Event Type
Malfunction
Date Received
June 7, 2013
Date of Event
April 5, 2013
Report Date
April 5, 2013
Manufacturer
MEDTRONIC, INC.
Product Code
KRG
PMA / PMN Number
P890003
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PRODUCT EVENT SUMMARY: ANALYSIS CONFIRMED THE CUSTOMER COMMENT THAT THE PROGRAMMER FROZE WHEN BEING POWERED ON. THE HARD DRIVE WAS RECONFIGURED AND THE SOFTWARE RELOADED. CONCOMITANT PRODUCTS: PRODUCT ID 2067 RADIO FREQUENCY PROGRAMMER HEAD. (B)(4).

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 PROGRAMMER FROZE BY THE MEDTRONIC LOGO WHEN POWERED ON. 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 THAT THE PROGRAMMER FROZE BY THE MEDTRONIC LOGO WHEN POWERED ON. 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
253069 CARELINK PROGRAMMER, PACEMAKER KRG MEDTRONIC, INC. 2090

Patients

Seq Age Sex Outcome Treatment
1