FDA Adverse Event Injury Summary report: N

LEAD ENGUARD BIF PF DFT 100

MDR report key: 82604 · Received April 8, 1997

Report

Report Number
1316542-1997-00714
Event Type
Injury
Date Received
April 8, 1997
Report Date
March 28, 1997
Manufacturer
TELECTRONICS PACING SYSTEMS
Product Code
DTB
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

REPORT RECEIVED OF LEAD DISLODGEMENT. LEAD WAS SUCCESSFULLY REPOSITIONED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LEAD ENGUARD BIF PF DFT 100 Implant CARDIOVASCULAR PERMANENT ELECTRODE DTB TELECTRONICS PACING SYSTEMS 040-068 NA

Patients

Seq Age Sex Outcome Treatment
1 77 YR Required Intervention