FDA Adverse Event Malfunction Summary report: N

REPLY

MDR report key: 4276201 · Received November 25, 2014

Report

Report Number
1000165971-2014-00652
Event Type
Malfunction
Date Received
November 25, 2014
Date of Event
November 12, 2014
Report Date
November 21, 2014
Manufacturer
SORIN GROUP ITALIA S.R.L. - CRM FACILITY
Product Code
NVZ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE MODEL INVOLVED IN THIS MDR REPORT IS NOT APPROVED IN THE U.S.; HOWEVER, IT IS SIMILAR TO REPLY DR OR SR MODELS APPROVED UNDER P950029.

Description of Event or Problem · 1

THE PHYSICIAN REPORTED LEAD CONNECTION DIFFICULTIES DURING THE IMPLANT ATTEMPT OF THE SUBJECT PACEMAKER.

Description of Event or Problem · 1

THE PHYSICIAN REPORTED LEAD CONNECTION DIFFICULTIES DURING THE IMPLANT ATTEMPT OF THE SUBJECT PACEMAKER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
764658 REPLY NVZ SORIN GROUP ITALIA S.R.L. - CRM FACILITY REPLY VDR S0030

Patients

Seq Age Sex Outcome Treatment
1