MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2013-10-30 for GUIDANT * 511211 manufactured by Greatbatch Medical.
[3966731]
Epicardial pacing lead failed and required replacement.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3516546 |
| MDR Report Key | 3516546 |
| Date Received | 2013-10-30 |
| Date of Report | 2013-10-30 |
| Date of Event | 2013-10-29 |
| Report Date | 2013-10-30 |
| Date Reported to FDA | 2013-10-30 |
| Date Reported to Mfgr | 2013-12-12 |
| Date Added to Maude | 2013-12-12 |
| Event Key | 0 |
| Report Source Code | User Facility report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | RISK MANAGER |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | GUIDANT |
| Generic Name | ELECTRODE, PACING, CARDIOVERSION |
| Product Code | NHW |
| Date Received | 2013-10-30 |
| Returned To Mfg | 2013-10-29 |
| Model Number | * |
| Catalog Number | 511211 |
| Lot Number | * |
| ID Number | * |
| Device Availability | R |
| Device Age | 4 YR |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | GREATBATCH MEDICAL |
| Manufacturer Address | 10000 WEHRLE DRIVE CLARENCE NY 14031 US 14031 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2013-10-30 |