FDA Adverse Event Other Summary report: N

ST JUDE MEDICAL

MDR report key: 389765 · Received April 22, 2002

Report

Report Number
MW1024782
Event Type
Other
Date Received
April 22, 2002
Date of Event
January 3, 2002
Report Date
January 11, 2002
Manufacturer
ST JUDE MEDICAL
Product Code
DXY
Report Source
Voluntary report
Reporter Location
WV, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

DUAL CHAMBER PERMANENT PACER GENERATOR FAILURE NOTED IMMEDIATELY AFTER INSERTION WHILE IN RECOVERY ROOM. RETURNED TO OR FOR REINSERTION OF ANOTHER PACER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ST JUDE MEDICAL BIPOLAR PERMANENT IMPLANTABLE GENERATOR DXY ST JUDE MEDICAL 5346 *

Patients

Seq Age Sex Outcome Treatment
1 82 YR Other MODEL # 5346 ST JUDE MEDICAL PACER GENERATOR.