FDA Adverse Event Malfunction Summary report: N

CARELINK

MDR report key: 3992488 · Received August 8, 2014

Report

Report Number
2182208-2014-02392
Event Type
Malfunction
Date Received
August 8, 2014
Date of Event
June 20, 2014
Report Date
June 20, 2014
Manufacturer
MEDTRONIC, INC.
Product Code
KRG
PMA / PMN Number
P890003
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

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 AN ERROR HAPPENED DURING THE BOOT UP PHASE. CALLER CYCLED POWER AND THE ERROR CLEARED. THE PROGRAMMER REMAINS IN USE. THERE WAS NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
472017 CARELINK PROGRAMMER, PACEMAKER KRG MEDTRONIC, INC. 2090W

Patients

Seq Age Sex Outcome Treatment
1