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