MAUDE MDR 2595301

MDR report key
2595301
Report number
1028232-2012-01347
Event key
0
Event type
3
Date of event
2012-05-17
Date received
2012-05-29
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 SD 60/16ICD LEADBIOTRONIK ST & CO. KGLWS363303363303* N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12012-05-2901. O

Event Narratives#

D

Patient 1

THIS LEAD WAS REPORTED TO DEMONSTRATE NOISE AND WILL BE REVISED. THERE ARE NO ADVERSE EVENTS REPORTED FOR THIS PT. (B)(6) 2012 - AS OF TODAY, ALL AVAILABLE INFO SUGGESTS THIS LEAD REMAINS IMPLANTED.