FDA Adverse Event Injury Summary report: N

SETROX S 45

MDR report key: 790198 · Received November 29, 2006

Report

Report Number
1028232-2006-00236
Event Type
Injury
Date Received
November 29, 2006
Date of Event
September 9, 2006
Report Date
October 26, 2006
Manufacturer
BIOTRONIK GMBH AND CO
Product Code
DTB
PMA / PMN Number
p950037
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

SYSTEM EXPLANTED DUE TO INFECTION AND DISCARDED BY HOSPITAL. SETROX S 53, MDR 1028232-06-0235. PHILOS DR, MDR 1028232-06-0234.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SETROX S 45 PACER LEAD DTB BIOTRONIK GMBH AND CO 350973 *

Patients

Seq Age Sex Outcome Treatment
1 55 YR Hospitalization