FDA Adverse Event Malfunction Summary report: N

CARELINK

MDR report key: 3862282 · Received June 10, 2014

Report

Report Number
2182208-2014-01702
Event Type
Malfunction
Date Received
June 10, 2014
Date of Event
March 6, 2014
Report Date
April 1, 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. NO INFORMATION TO SUGGEST A DEVICE RELATED ADVERSE EVENT OR PRODUCT PROBLEM WAS RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. PRODUCT EVENT SUMMARY: ANALYSIS FOUND THAT THE ANALYZER WOULD NOT COMMUNICATE WITH THE PROGRAMMER. (B)(4).

Description of Event or Problem · 1

THE ANALYZER WAS RETURNED TO THE MANUFACTURER, ANALYZED, AND TESTED OUT OF SPECIFICATION. NO PATIENT INVOLVEMENT OR COMPLICATIONS WERE REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
337728 CARELINK PROGRAMMER, PACEMAKER KRG MEDTRONIC, INC. 229047

Patients

Seq Age Sex Outcome Treatment
1 2090 PROGRAMMER