FDA Adverse Event Malfunction Summary report: N

CARELINK

MDR report key: 3153538 · Received June 8, 2013

Report

Report Number
2182208-2013-01447
Event Type
Malfunction
Date Received
June 8, 2013
Date of Event
March 26, 2013
Report Date
March 26, 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

PRODUCT EVENT SUMMARY: ANALYSIS CONFIRMED THE KEYBOARD LID WAS LOOSE AND NEEDED REPAIR. THE PROGRAMMER DID NOT COMMUNICATE WITH THE ANALYZER. THE PROGRAMMER DOES COMMUNICATE WITH A KNOWN GOOD ANALYZER. IT WAS ALSO NOTED THAT THE TABS ON THE POWER CORD DOOR WERE BROKEN OFF.

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 RF HEAD; PRODUCT ID R2290 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 THE SCREW COULD NOT BE RETRACTED TO CHECK THE ANALYZER. THE ANALYZER IS NOT CONNECTED. THE ANALYZER WAS TURNED ON TO DO A CASE/CHECK/TEST AND UNABLE TO FIX. IT WAS ALSO REPORTED THE LID TO KEYBOARD NEEDS TO BE REPAIR. THE ANALYZER AND PROGRAMMER WERE 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
256885 CARELINK PULSE-GENERATOR, PACEMAKER, IMPLANTABLE DXY MEDTRONIC, INC. 2090W

Patients

Seq Age Sex Outcome Treatment
1