BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LASERPOR 030-236

    MDR report key: 77025 · Received March 15, 1997

    Report

    Report Number
    1316542-1997-00522
    Event Type
    Injury
    Date Received
    March 15, 1997
    Date of Event
    August 23, 1996
    Report Date
    March 14, 1997
    Manufacturer
    TELECTRONICS PACING SYSTEMS
    Product Code
    DTB
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    THE LEAD WAS CUT & CAPPED DUE TO A REPORT OF LEAD LOSS OF SENSING AND CAPTURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LASERPOR 030-236 Implant CARDIOVASCULAR PERMANENT PACEMAKER ELECTRODE DTB TELECTRONICS PACING SYSTEMS 030-236 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 74 YR Required Intervention