FDA Adverse Event Malfunction Summary report: N

CARELINK

MDR report key: 3153193 · Received June 8, 2013

Report

Report Number
2182208-2013-01398
Event Type
Malfunction
Date Received
June 8, 2013
Date of Event
March 20, 2013
Report Date
March 20, 2013
Manufacturer
MEDTRONIC, INC.
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

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

PRODUCT EVENT SUMMARY: COULD NOT CONFIRM THE REPORTED EVENT; THE ANALYZER PASSED ALL FUNCTIONAL AND SYSTEM TESTS. ANALYSIS FOUND THE PATIENT CONNECTOR IS WORN.

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 ANALYZER HAD OVERSENSING ISSUES. THE ANALYZER 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
254879 CARELINK PULSE-GENERATOR, PACEMAKER, IMPLANTABLE DXY MEDTRONIC, INC. 229047

Patients

Seq Age Sex Outcome Treatment
1