BEUDAMED
    FDA Adverse Event Other Summary report: N

    LIFEPAK 12 MONITOR/DEFIBRILLATOR

    MDR report key: 521591 · Received November 3, 2003

    Report

    Report Number
    521591
    Event Type
    Other
    Date Received
    November 3, 2003
    Date of Event
    October 3, 2003
    Report Date
    October 8, 2003
    Manufacturer
    MEDTRONIC PHYSIO-CONTROL
    Product Code
    LDD
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    MD, US
    Reporter Occupation
    PARAMEDIC

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIFEPAK 12 MONITOR/DEFIBRILLATOR MONITOR/DEFIBRILLATOR LDD MEDTRONIC PHYSIO-CONTROL VLP12-02-000891 *

    Patients

    Seq Age Sex Outcome Treatment
    1 81 YR Other