FDA Adverse Event
Malfunction
Summary report: N
CARELINK
MDR report key: 3992518
·
Received August 8, 2014
Report
- Report Number
- 2182208-2014-02388
- Event Type
- Malfunction
- Date Received
- August 8, 2014
- Date of Event
- May 30, 2014
- Report Date
- May 30, 2014
- Manufacturer
- MEDTRONIC, INC.
- Product Code
- KRG
- PMA / PMN Number
- P890003
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- VA, US
- Reporter Occupation
- HEALTH PROFESSIONAL
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 PROGRAMMER POWERED UP TO A BLACK SCREEN AND FOREIGN LANGUAGES. TECHNICAL SUPPORT (TS) TOLD THE CALLER TO CONTACT THEIR LOCAL MEDTRONIC REPRESENTATIVE TO HAVE IT REPLACED OR HAVE THE SERVICE DISK RAN. THE STATUS OF THE PROGRAMMER IS UNKNOWN. THERE WAS NO PATIENT INVOLVEMENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 467305 | CARELINK | PROGRAMMER, PACEMAKER | KRG | MEDTRONIC, INC. | 2090AA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |