FDA Adverse Event Malfunction Summary report: N

CARELINK

MDR report key: 4161062 · Received October 10, 2014

Report

Report Number
2182208-2014-02750
Event Type
Malfunction
Date Received
October 10, 2014
Date of Event
July 25, 2014
Report Date
July 25, 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 FOUND THE PROGRAMMER WAS UNABLE TO INTERROGATE CERTAIN DEVICES WHEN THE ¿ALLOW WIRELESS COMMUNICATION¿ BOX IS CHECKED; HARD DRIVE WAS REIMAGED AND SOFTWARE RELOADED TO RESOLVE ISSUE. ANALYSIS ALSO FOUND THE PROGRAMMER WAS UNABLE TO FIND ANY WIRELESS DEVICES DURING FIND PATIENT SEARCHES; RF (RADIO FREQUENCY) TRANSCEIVER FOUND OUT OF ELECTRICAL SPECIFICATION. PARTIAL CUT FOUND IN ANTENNA CABLE BEHIND UPPER HINGE, THE SYSTEM FAN IS NOISY, POWER CORD BAY HAS BROKEN TAB, AND KEYBOARD IS SEPARATING. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THERE WAS INTERMITTENT LOSS OF TELEMETRY REPORTED. THE PROGRAMMER WAS RETURNED FOR REPAIR. NO PATIENT COMPLICATIONS WERE REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
642514 CARELINK PROGRAMMER, PACEMAKER KRG MEDTRONIC, INC. 2090

Patients

Seq Age Sex Outcome Treatment
1 2067 RADIO FREQUENCY HEAD