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 |