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