FDA Adverse Event Malfunction Summary report: N

CARELINK

MDR report key: 3153376 · Received June 8, 2013

Report

Report Number
2182208-2013-01420
Event Type
Malfunction
Date Received
June 8, 2013
Date of Event
April 23, 2013
Report Date
April 23, 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: ANALYSIS CONFIRMED THE CUSTOMER COMMENT THAT THE PROGRAMMER DISPLAY SCREEN AND THE STYLUS WERE OUT OF ALIGNMENT. THE OVERLAY/BEZEL ASSEMBLY WAS REPLACED AND THE STYLUS CALIBRATED. (B)(4).

Additional Manufacturer Narrative · 1

PRODUCT EVENT SUMMARY: ANALYSIS CONFIRMED THE CUSTOMER COMMENT THAT THE PROGRAMMER DISPLAY SCREEN AND THE STYLUS WERE OUT OF ALIGNMENT. THE OVERLAY/BEZEL ASSEMBLY WAS REPLACED AND THE STYLUS CALIBRATED. (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. CONCOMITANT PRODUCTS: PRODUCT ID 2067L RADIO FREQUENCY PROGRAMMER HEAD; PRODUCT ID 229047 SOFTWARE ANALYZER. (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 DISPLAY SCREEN OF THE PROGRAMMER AND THE STYLUS WERE OUT OF ALIGNMENT, AND ATTEMPTS TO RE-CALIBRATE WERE NOT SUCCESSFUL. THE PROGRAMMER WAS RETURNED FOR SERVICE. IT WAS INDICATED THAT THERE WAS NO PATIENT INVOLVEMENT ASSOCIATED WITH THIS EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DISPLAY SCREEN OF THE PROGRAMMER AND THE STYLUS WERE OUT OF ALIGNMENT, AND ATTEMPTS TO RE-CALIBRATE WERE NOT SUCCESSFUL. THE PROGRAMMER WAS RETURNED FOR SERVICE. IT WAS INDICATED THAT THERE WAS NO PATIENT INVOLVEMENT ASSOCIATED WITH THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
258599 CARELINK PULSE-GENERATOR, PACEMAKER, IMPLANTABLE DXY RICE CREEK MFG 2090

Patients

Seq Age Sex Outcome Treatment
1