BEUDAMED
    FDA Adverse Event Death Summary report: N

    MEDTRONIC

    MDR report key: 36521 · Received August 27, 1996

    Report

    Report Number
    36521
    Event Type
    Death
    Date Received
    August 27, 1996
    Date of Event
    August 22, 1996
    Report Date
    August 23, 1996
    Manufacturer
    MEDTRONIC, INC.
    Product Code
    DXY
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    FL, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PACER WAS NOT SENSING CORRECTLY. WOULD NOT PACE THE VENTRICLE AT THE RATE THAT WAS DIALED IN. ANOTHER PACER WAS USED. PT EXPIRED. DEATH NOT ATTRIBUTED TO PACER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDTRONIC Implant PACER DXY MEDTRONIC, INC. 5330 *

    Patients

    Seq Age Sex Outcome Treatment
    1 74 YR Death| R