BEUDAMED
    FDA Adverse Event Injury Summary report: N

    REVEAL XT

    MDR report key: 3744824 · Received April 11, 2014

    Report

    Report Number
    3004209178-2014-06899
    Event Type
    Injury
    Date Received
    April 11, 2014
    Date of Event
    October 4, 2013
    Report Date
    January 16, 2014
    Manufacturer
    MEDTRONIC MED REL MEDTRONIC PUERTO RICO
    Product Code
    DSI
    PMA / PMN Number
    K103764
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SP
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    THIS INFORMATION IS BASED ENTIRELY ON JOURNAL LITERATURE. THIS EVENT OCCURRED OUTSIDE THE US. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. THE YEAR IS VALID FOR THE PATIENT¿S DATE OF BIRTH. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. REFERENCED ARTICLE: IMPLANTABLE LOOP RECORDER ALLOWS AN ETIOLOGIC DIAGNOSIS IN ONE-THIRD OF PATIENTS - RESULTS OF THE SPANISH REVEAL REGISTRY. CIRC. J. 2013;77(10):2535-2541. (B)(4).

    Description of Event or Problem · 1

    A JOURNAL ARTICLE WAS REVIEWED WHICH CONTAINED INFORMATION REGARDING THIS IMPLANTABLE LOOP RECORDER (ILR). INFORMATION OBTAINED THROUGH FOLLOW UP INDICATED THAT THE ILR SHOWED "NOISE." THE STATUS OF THE ILR IS UNKNOWN. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    221750 REVEAL XT DETECTOR AND ALARM, ARRHYTHMIA DSI MEDTRONIC MED REL MEDTRONIC PUERTO RICO 9529

    Patients

    Seq Age Sex Outcome Treatment
    1 00068 YR Required Intervention