BEUDAMED
    FDA Adverse Event Injury Summary report: N

    AROX 45 JBP

    MDR report key: 777036 · Received November 3, 2006

    Report

    Report Number
    1028232-2006-00243
    Event Type
    Injury
    Date Received
    November 3, 2006
    Date of Event
    September 20, 2006
    Report Date
    October 30, 2006
    Manufacturer
    BIOTRONIK GMBH AND CO.
    Product Code
    DTB
    PMA / PMN Number
    K021217
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    SYSTEM EXPLANTED DUE TO INFECTION. SELOX ST 53, MDR 1028232-06-0242; PHILOS DR, MDR 1028232-06-0241.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AROX 45 JBP PACER LEAD DTB BIOTRONIK GMBH AND CO. 338022 *

    Patients

    Seq Age Sex Outcome Treatment
    1 70 YR Hospitalization