FDA Adverse Event Malfunction Summary report: N

CARELINK

MDR report key: 3152554 · Received June 7, 2013

Report

Report Number
2182208-2013-01540
Event Type
Malfunction
Date Received
June 7, 2013
Date of Event
April 23, 2013
Report Date
April 23, 2013
Manufacturer
MEDTRONIC, INC.
Product Code
KRG
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: ANALYSIS CONFIRMED THE CUSTOMER COMMENT THAT THE PROGRAMMER HEAD HAD INTERMITTENT TELEMETRY, THE HEAD FAILED ALL UPLINK AMPLITUDE TESTS AND THE RUBBER PORTION OF THE HEAD LABEL WAS GONE. THE HEAD'S CABLE AND LABEL WERE REPLACED AND THE PROGRAMMER HEAD PASSED ALL FINAL ELECTRICAL AND BENCH SYSTEMS TEST. (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 THAT THE RADIO FREQUENCY PROGRAMMER HEAD WAS UNABLE TO RECOGNIZE, OR INTERROGATE A PATIENT'S IMPLANTED HEART DEVICE. IT WAS NOTED THAT NUMEROUS TRIES WERE MADE. THE PROGRAMMER HEAD WAS RETURNED FOR SERVICE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE RADIO FREQUENCY PROGRAMMER HEAD WAS UNABLE TO RECOGNIZE, OR INTERROGATE A PATIENT'S IMPLANTED HEART DEVICE. IT WAS NOTED THAT NUMEROUS TRIES WERE MADE. THE PROGRAMMER HEAD WAS RETURNED FOR SERVICE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
253203 CARELINK PROGRAMMER, PACEMAKER KRG MEDTRONIC, INC. 2067L

Patients

Seq Age Sex Outcome Treatment
1