FDA Adverse Event Malfunction Summary report: N

PULSE-GENERATOR, DUAL CHAMBER, IMPLANTABLE

MDR report key: 3993914 · Received August 8, 2014

Report

Report Number
2183613-2014-01061
Event Type
Malfunction
Date Received
August 8, 2014
Date of Event
May 22, 2014
Report Date
May 22, 2014
Manufacturer
MEDTRONIC MILACA, INC.
Product Code
LWP
PMA / PMN Number
P820003
Product Problem
Yes
Report Source
Manufacturer report
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 THERE WAS "FLUID INTRUSION" INTO THE EXTERNAL PULSE GENERATOR (EPG). THE EPG IS NO LONGER SERVICED BY THE MANUFACTURER AND HAS BEEN OBSOLETE. THE STATUS OF THE EPG IS UNKNOWN. THERE WAS NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
471436 PULSE-GENERATOR, DUAL CHAMBER, IMPLANTABLE LWP MEDTRONIC MILACA, INC. 5388

Patients

Seq Age Sex Outcome Treatment
1