FDA Adverse Event Injury Summary report: N

SETROX S 53

MDR report key: 3854293 · Received June 6, 2014

Report

Report Number
1028232-2014-01801
Event Type
Injury
Date Received
June 6, 2014
Date of Event
June 5, 2013
Report Date
June 11, 2013
Manufacturer
BIOTRONIK SE & CO. KG
Product Code
NVN
PMA / PMN Number
P950037
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE IS CURRENTLY NOT AVAILABLE FOR ANALYSIS. NO CONCLUSION CAN BE DRAWN AT THIS TIME. THE INVESTIGATION WILL BE RE-OPENED SHOULD ADDITIONAL DATA BECOME AVAILABLE.

Description of Event or Problem · 1

THIS LEAD WAS CAPPED DUE TO HIGH THRESHOLDS AND INCREASED IMPEDANCES WHILE REPLACING THE DEVICE, WHICH HAD REACHED EXPECTED ERI. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE, THIS FILE WILL BE UPDATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
332859 SETROX S 53 PACER LEAD NVN BIOTRONIK SE & CO. KG 350974

Patients

Seq Age Sex Outcome Treatment
1 73 YR Hospitalization