FDA Adverse Event Injury Summary report: N

REVEAL LINQ

MDR report key: 3992372 · Received August 8, 2014

Report

Report Number
9614453-2014-01983
Event Type
Injury
Date Received
August 8, 2014
Date of Event
June 25, 2014
Report Date
June 25, 2014
Manufacturer
IPG MFG SWITZERLAND
Product Code
DSI
PMA / PMN Number
K132649
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT'S IMPLANTABLE LOOP RECORDER COULD NOT ESTABLISH TELEMETRY, WITH THREE DIFFERENT PROGRAMMERS. THE DEVICE WAS EXPLANTED AND REPLACED. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
468771 REVEAL LINQ DETECTOR AND ALARM, ARRHYTHMIA DSI IPG MFG SWITZERLAND LNQ11

Patients

Seq Age Sex Outcome Treatment
1 00029 YR Hospitalization| R