FDA Adverse Event Other Summary report: N

GOODMAN CO. LTD

MDR report key: 926727 · Received March 29, 2007

Report

Report Number
2243801-2007-00011
Event Type
Other
Date Received
March 29, 2007
Date of Event
February 13, 2007
Report Date
March 23, 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 RETURNED TO THE MFR TO BE EVALUATED. THE RETURNED UNIT DID NOT PASS PROXIMAL CONTINUITY TESTING. THE PROXIMAL WIRE IS DISCONNECTED FROM PROXIMAL ELECTRODE. HOWEVER, SOLDER IS EVIDENT. THE PROXIMAL WIRE MAY HAVE DISCONNECTED FROM THE ELECTRODE DURING HANDLING. THIS INCIDENT MAY ALSO BE ATTRIBUTED TO THE UNIT BEING PASSED THROUGH A TIGHT INTRODUCER. NO SPECIFIC CONCLUSIONS CAN BE DRAWN.

Description of Event or Problem · 1

PACING FAILURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GOODMAN CO. LTD PACING CATHETER DYB B. BRAUN MEDICAL, INC. NA 60759225

Patients

Seq Age Sex Outcome Treatment
1 YR Other