FDA Adverse Event Malfunction Summary report: N

CARELINK

MDR report key: 3860066 · Received June 10, 2014

Report

Report Number
2182208-2014-01532
Event Type
Malfunction
Date Received
June 10, 2014
Date of Event
April 23, 2014
Report Date
April 23, 2014
Manufacturer
MEDTRONIC, INC.
Product Code
KRG
PMA / PMN Number
P890003
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. (B)(4).

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Additional Manufacturer Narrative · 1

PRODUCT EVENT SUMMARY: ANALYSIS FOUND THE STYLUS LOCATION ON THE DISPLAY INTERMITTENTLY DISPLAYED IN THE INCORRECT LOCATION, APPROXIMATELY 3 INCHES TO THE LEFT AND 1 INCH UP FROM THE STYLUS¿S PHYSICAL ACTUAL LOCATION ON THE DISPLAY OVERLAY. ANALYSIS ALSO FOUND THE PROGRAMMER WAS ABLE TO INTERROGATE A DEVICE WIRELESS AND NON-WIRELESS USING A KNOWN GOOD HEAD. UNABLE TO CONFIRM THE REPORTED SCREEN RE-BOOT ISSUE.

Description of Event or Problem · 1

IT WAS REPORTED THE STYLUS KEEPS UN-CALIBRATING. SCREEN WILL JUST RE-BOOT AT WILL. THE PROGRAMMER WAS 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
339718 CARELINK PROGRAMMER, PACEMAKER KRG MEDTRONIC, INC. 2090

Patients

Seq Age Sex Outcome Treatment
1