FDA Adverse Event Malfunction Summary report: N

CARELINK

MDR report key: 4830007 · Received June 10, 2015

Report

Report Number
2182208-2015-01822
Event Type
Malfunction
Date Received
June 10, 2015
Date of Event
March 27, 2015
Report Date
March 27, 2015
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 OF INCONSISTENT INTERROGATION AND NOTED THAT THE UPLINK TESTS WERE OUT OF SPECIFICATION, THEREFORE ITS CABLE WAS REPLACED. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE RADIOFREQUENCY PROGRAMMER HEAD WAS UNABLE TO INTERROGATE DEVICES CONSISTENTLY. THE PROGRAMMER HEAD WAS RETURNED FOR SERVICE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
378848 CARELINK PROGRAMMER, PACEMAKER KRG MEDTRONIC, INC. 2067

Patients

Seq Age Sex Outcome Treatment
1