MAUDE MDR 2287696

MDR report key
2287696
Report number
1028232-2011-02316
Event key
0
Event type
3
Date of event
2011-05-31
Date received
2011-10-05
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
2
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Address
6024 JEAN ROAD LAKE OSWEGO OR 97035 US
Phone
877-877-8772
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1LINOX SMART SD 65/18ICD LEADBIOTRONIK SE & CO. KGLWS359067359067Y N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12011-10-0501. H

Event Narratives#

D

Patient 1

THIS LEAD WAS EXPLANTED FOR AN UNK REASON DURING A REVISION FOR THE ASSOCIATED LV LEAD. SHOULD ADD'L INFO BECOME AVAILABLE, THIS EVENT WILL BE UPDATED.