FDA Adverse Event Malfunction Summary report: N

CARELINK

MDR report key: 3861121 · Received June 10, 2014

Report

Report Number
2182208-2014-01779
Event Type
Malfunction
Date Received
June 10, 2014
Date of Event
March 19, 2014
Report Date
April 29, 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

THIS REPORT IS BASED SOLELY ON DEVICE ANALYSIS. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. PRODUCT EVENT SUMMARY: RF (RADIO FREQUENCY) HEAD FAILED UPLINK FUNCTIONAL TEST; RF HEAD CABLE FOUND OUT OF ELECTRICAL SPECIFICATION. CONCOMITANT MEDICAL PRODUCTS: 229047 ANALYZER. (B)(4).

Description of Event or Problem · 1

THE RF (RADIO FREQUENCY) HEAD WAS RETURNED TO THE MANUFACTURER, ANALYZED AND TESTED OUT OF SPECIFICATION. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
342059 CARELINK PROGRAMMER, PACEMAKER KRG MEDTRONIC, INC. 2067L

Patients

Seq Age Sex Outcome Treatment
1 2090 PROGRAMMER