FDA Adverse Event
Malfunction
Summary report: N
BELOS VR-T
MDR report key: 474637
·
Received July 24, 2003
Report
- Report Number
- 1028232-2003-00243
- Event Type
- Malfunction
- Date Received
- July 24, 2003
- Date of Event
- March 21, 2003
- Report Date
- July 18, 2003
- Manufacturer
- BIOTRONIK GMBH & CO.
- Product Code
- MKJ
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Occupation
- INVALID DATA
Narratives
Description of Event or Problem · 1
VOLUNTARY FIRM INITIATED DEVICE PATIENT MANAGEMENT INFORMATION (PMI) IN 2003 THE MANUFACTURER NOTIFIED BIOTRONIK, INC THAT PRODUCT WAS SUBJECT TO THE ATTACHED MANUFACTURER TECHNICAL NOTE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | BELOS VR-T | ICD | MKJ | BIOTRONIK GMBH & CO. | 331 135 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNKNOWN | Life Threatening |