BEUDAMED
    FDA Adverse Event Other Summary report: N

    MEDTRONIC

    MDR report key: 607693 · Received May 31, 2005

    Report

    Report Number
    607693
    Event Type
    Other
    Date Received
    May 31, 2005
    Date of Event
    March 16, 2004
    Manufacturer
    *
    Product Code
    LWS
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    TX, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    CORONARY SINUS LEAD DISSECTED THE VEIN. PROCEDURE ABORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDTRONIC * LWS * 2817 LV LEAD *

    Patients

    Seq Age Sex Outcome Treatment
    1 79 YR Other