FDA Adverse Event Other Summary report: N

PHILOS SR

MDR report key: 567876 · Received January 12, 2005

Report

Report Number
1028232-2004-00158
Event Type
Other
Date Received
January 12, 2005
Date of Event
December 16, 2004
Report Date
January 3, 2005
Manufacturer
BIOTRONIK, INC.
Product Code
DXY
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
INVALID DATA

Narratives

Description of Event or Problem · 1

OOS REPORT FORM STATES 'PROGRAMMING TELEMETRY DIFFICULTY.

Description of Event or Problem · 1

OOS REPORT FORM STATES PROGRAMMING TELEMETRY DIFFICULTY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PHILOS SR PACEMAKER DXY BIOTRONIK, INC. 331 446 NA

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Hospitalization