FDA Adverse Event Other Summary report: N

PHILOS DR ACC

MDR report key: 736846 · Received July 17, 2006

Report

Report Number
1028232-2006-00131
Event Type
Other
Date Received
July 17, 2006
Date of Event
January 1, 2006
Report Date
July 10, 2006
Manufacturer
BIOTRONIK GMBH AND CO
Product Code
DXY
PMA / PMN Number
P950037
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

LEADS WERE EXPLANTED IN 2006, DUE TO INFECTION. LEADS WERE LASER EXTRACTED. THE PT HAD HAD TWO PREVIOUS POCKET REVISION PROCEDURES. LEADS INVOLVED: POLYROX 45 JBP, MDR 06-0132 AND POLYROX 53/13 BP, MDR 06-0133. SIX DAYS LATER, REP REPORTED THAT THE INFECTION CLEARED AND THE PT WAS IMPLANTED WITH A NEW SYSTEM TODAY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PHILOS DR ACC PACEMAKER DXY BIOTRONIK GMBH AND CO 337 157 *

Patients

Seq Age Sex Outcome Treatment
1 62 YR Hospitalization