BEUDAMED
    FDA Adverse Event Injury Summary report: N

    REVEAL PLUS

    MDR report key: 3863046 · Received June 10, 2014

    Report

    Report Number
    3004209178-2014-10965
    Event Type
    Injury
    Date Received
    June 10, 2014
    Date of Event
    October 4, 2013
    Report Date
    January 16, 2014
    Manufacturer
    MEDTRONIC MED REL MEDTRONIC PUERTO RICO
    Product Code
    MXC
    PMA / PMN Number
    K994331
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SP
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    THIS INFORMATION IS BASED ENTIRELY ON JOURNAL LITERATURE. THIS EVENT OCCURRED OUTSIDE THE US. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. PATIENT INFORMATION IS LIMITED DUE TO CONFIDENTIALITY CONCERNS. REFERENCED ARTICLE: IMPLANTABLE LOOP RECORDER ALLOWS AN ETIOLOGIC DIAGNOSIS IN ONE-THIRD OF PATIENTS - RESULTS OF THE (B)(4) REVEAL REGISTRY. CIRC. J. 2013;77(10):2535-2541. (B)(4).

    Description of Event or Problem · 1

    A JOURNAL ARTICLE WAS REVIEWED WHICH CONTAINED INFORMATION REGARDING THIS IMPLANTABLE LOOP RECORDER (ILR). INFORMATION OBTAINED THROUGH FOLLOW UP INDICATED THAT THE ILR WAS EXPLANTED DUE TO DECUBITUS. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    338217 REVEAL PLUS RECORDER,EVENT,IMPLANTABLE CARDIAC,(WITHOUT ARRHYTHMIA DETECTION) MXC MEDTRONIC MED REL MEDTRONIC PUERTO RICO 9526

    Patients

    Seq Age Sex Outcome Treatment
    1 00058 YR Hospitalization| R