FDA Adverse Event Malfunction Summary report: N

CARELINK

MDR report key: 4161020 · Received October 10, 2014

Report

Report Number
2182208-2014-02760
Event Type
Malfunction
Date Received
October 10, 2014
Date of Event
July 28, 2014
Report Date
July 28, 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. PRODUCT EVENT SUMMARY: ANALYSIS CONFIRMED THE CUSTOMER COMMENT THAT THE PROGRAMMER WAS UNABLE TO INTERROGATE AND THEREFORE THE LINK ELECTRONIC MODULE (LEM) BOARD WAS REPLACED AND CALIBRATED. IT WAS FURTHER REPORTED THAT THE UPPER HINGE PLATE WAS CRACKED AND IT WAS REPLACED. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PROGRAMMER WAS UNABLE TO INTERROGATE IMPLANTABLE HEART DEVICES. MULTIPLE NORMALLY FUNCTIONING RADIOFREQUENCY PROGRAMMER HEADS WERE USED. THE PROGRAMMER WAS RETURNED FOR SERVICE. THERE WAS NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
642521 CARELINK PROGRAMMER, PACEMAKER KRG MEDTRONIC, INC. 2090W

Patients

Seq Age Sex Outcome Treatment
1 229047 SOFTWARE ANALYZER