FDA Adverse Event Other Summary report: N

GOODMAN CO. LTD

MDR report key: 823314 · Received March 1, 2007

Report

Report Number
2243801-2007-00008
Event Type
Other
Date Received
March 1, 2007
Date of Event
January 30, 2007
Report Date
February 21, 2007
Manufacturer
B. BRAUN MEDICAL, INC.
Product Code
DYB
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE ACTUAL DEVICE IN THE INCIDENT WAS NOT RETURNED TO THE MANUFACTURER TO BE EVALUATED. WITHOUT THE SAMPLE A THOROUGH EVALUATION COULD NOT BE PERFORMED. NO SPECIFIC CONCLUSIONS CAN BE DRAWN.

Description of Event or Problem · 1

PACING FAILURE. UNABLE TO PACE. CONSIDERED A BROKEN CABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GOODMAN CO. LTD PACING CATHETER DYB B. BRAUN MEDICAL, INC. NA 60893765

Patients

Seq Age Sex Outcome Treatment
1 YR Other