FDA Adverse Event Other Summary report: N

GOODMAN CO. LTD

MDR report key: 850733 · Received February 28, 2007

Report

Report Number
2243801-2007-00009
Event Type
Other
Date Received
February 28, 2007
Date of Event
January 30, 2007
Report Date
February 26, 2007
Manufacturer
B. BRAUN MEDICAL, INC.
Product Code
DYB
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE ACTUAL DEVICE IN THIS INCIDENT WAS RETURNED TO THE MFR TO BE EVALUATED. THE RETURNED UNIT PASSES ALL CONTINUITY TESTING AND WAS NOTED TO FUNCTION PROPERLY. NO DEFECTS WERE NOTED IN THE RETURNED UNIT. NO SPECIFIC CONCLUSIONS CAN BE DRAWN.

Description of Event or Problem · 1

PACING FAILURE. UNABLE TO PRODUCE A WAVE FLOW.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GOODMAN CO. LTD PACING CATHETER DYB B. BRAUN MEDICAL, INC. NA 60798888

Patients

Seq Age Sex Outcome Treatment
1 YR Other