FDA Adverse Event
Injury
Summary report: N
LINOX SMART S DX 65/17
MDR report key: 3970919
·
Received July 31, 2014
Report
- Report Number
- 1028232-2014-002648
- Event Type
- Injury
- Date Received
- July 31, 2014
- Date of Event
- July 16, 2014
- Report Date
- July 21, 2014
- Manufacturer
- BIOTRONIK SE & CO. KG
- Product Code
- NVY
- PMA / PMN Number
- P980023
- Adverse Event
- 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 DISLODGMENT. THE PHYSICIAN WAS GOING TO REPOSITION THE LEAD BUT THERE WAS TISSUE IN THE HELIX SO ANOTHER LEAD WAS IMPLANTED. 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 |
|---|---|---|---|---|---|---|---|
| 447821 | LINOX SMART S DX 65/17 | ICD LEAD | NVY | BIOTRONIK SE & CO. KG | 365501 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 55 YR | Hospitalization |