BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ALLURE QUADRA RF

    MDR report key: 3920677 · Received July 8, 2014

    Report

    Report Number
    2017865-2014-14277
    Event Type
    Malfunction
    Date Received
    July 8, 2014
    Date of Event
    May 12, 2014
    Manufacturer
    ST. JUDE MEDICAL, INC., CRMD
    Product Code
    DXY
    PMA / PMN Number
    P880086
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    KY, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT DURING IMPLANT, THE PHYSICIAN HAD DIFFICULTY INSERTING THE LEAD CONNECTOR INTO THE ATRIAL PORT OF THE PULSE GENERATOR. THE DEVICE WAS SUCCESSFULLY IMPLANTED. THE PATIENT WOULD BE MONITORED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    396887 ALLURE QUADRA RF IMPLANTABLE PACEMAKER PULSE GENERATOR DXY ST. JUDE MEDICAL, INC., CRMD PM3242 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR