FDA Adverse Event Injury Summary report: N

SETROX S 45

MDR report key: 3965051 · Received July 29, 2014

Report

Report Number
1028232-2014-002652
Event Type
Injury
Date Received
July 29, 2014
Date of Event
January 17, 2014
Report Date
July 18, 2014
Manufacturer
BIOTRONIK SE & CO. KG
Product Code
NVN
PMA / PMN Number
P950037
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE IS CURRENTLY NOT AVAILABLE FOR ANALYSIS. NO CONCLUSION CAN BE DRAWN AT THIS TIME. THE INVESTIGATION WILL BE RE-OPENED SHOULD ADDITIONAL DATA BECOME AVAILABLE.

Description of Event or Problem · 1

THIS LEAD WAS EXPLANTED AND REPLACED DUE TO NO CAPTURE OR SENSING. THE PATIENT APPEARED TO HAVE A SILENT ATRIUM. THERE WERE NO ADVERSE PATIENT EVENTS REPORTED. THE HOSPITAL RETAINED THE DEVICE. SHOULD ADDITIONAL INFORMATION BE RECEIVED, THIS FILE WILL BE UPDATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
441155 SETROX S 45 PACER LEAD NVN BIOTRONIK SE & CO. KG 350973

Patients

Seq Age Sex Outcome Treatment
1 85 YR Hospitalization