FDA Adverse Event
Malfunction
Summary report: N
CARELINK
MDR report key: 3992678
·
Received August 8, 2014
Report
- Report Number
- 2182208-2014-02374
- Event Type
- Malfunction
- Date Received
- August 8, 2014
- Date of Event
- May 29, 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
THIS REPORT IS BASED SOLELY ON DEVICE ANALYSIS. NO INFORMATION TO SUGGEST A DEVICE RELATED ADVERSE EVENT OR PRODUCT PROBLEM WAS RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. PRODUCT EVENT SUMMARY: ANALYSIS FOUND THAT THE DEVICE FAILED DOWNLINK SENSE AND TRANSMIT CURRENT TESTING. AFTER THE CABLE WAS REPLACED THE DEVICE PASSED FUNCTIONAL AND SYSTEMS TESTS. THE CABLE WAS OUT OF ELECTRICAL SPECIFICATION. (B)(4).
Description of Event or Problem · 1
THE RADIOFREQUENCY (RF) HEAD WAS RETURNED TO THE MANUFACTURER, ANALYZED, AND TESTED OUT OF SPECIFICATION. NO PATIENT INVOLVEMENT OR COMPLICATIONS WERE REPORTED AS A RESULT OF THIS EVENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 471080 | CARELINK | PROGRAMMER, PACEMAKER | KRG | MEDTRONIC, INC. | 2067 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |