BEUDAMED
    FDA Adverse Event Other Summary report: N

    MEDTRONIC, INC.

    MDR report key: 747037 · Received October 13, 2005

    Report

    Report Number
    MW1036928
    Event Type
    Other
    Date Received
    October 13, 2005
    Date of Event
    July 12, 2005
    Report Date
    October 13, 2005
    Manufacturer
    MEDTRONIC, INC.
    Product Code
    LWS
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TN, US
    Reporter Occupation
    NO INFORMATION

    Narratives

    Description of Event or Problem · 1

    TACHY LEAD MODEL 6947 WAS REPLACED DUE TO SENSING ISSUES, NOISE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDTRONIC, INC. TACHY LEAD LWS MEDTRONIC, INC. 6947 *

    Patients

    Seq Age Sex Outcome Treatment
    1 55 YR Other