REOCOR D 365529 SEE MODEL NO.

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2015-11-11 for REOCOR D 365529 SEE MODEL NO. manufactured by Biotronik Se & Co. Kg.

Event Text Entries

[30983485] Ous mdr - the following is what was reported:at 12:30 the monitor of my patient has started alarming for ventricular tachycardia. The pacing box the patient was connected to started firing at 120 - 140 bpm. This pacing box was set as a backup with the parameters: mode:ddd, rate:60, av delay:200, atrial sensitivity:0. 3, atrial output: 6, ventricular sensitivity: 6, ventricular output: 10. Immediately contacted with a senior nurse who changed the parameters of the pacing box and reduced the rate until 40; however, even after these changes, the pacing box was still firing at the same rate. The patient had an underlying rhythm of sinus rhythm with bundle branch block of 80-95 bpm. The device has been returned for analysis.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1028232-2015-04044
MDR Report Key5217014
Date Received2015-11-11
Date of Report2015-10-29
Date of Event2015-09-24
Date Mfgr Received2015-10-29
Date Added to Maude2015-11-11
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer Street6024 JEAN ROAD
Manufacturer CityLAKE OSWEGO OR 97035
Manufacturer CountryUS
Manufacturer Postal97035
Manufacturer Phone8772459800
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameREOCOR D
Generic NameEXTERNAL PACEMAKER
Product CodeOVJ
Date Received2015-11-11
Model Number365529
Catalog NumberSEE MODEL NO.
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerBIOTRONIK SE & CO. KG
Manufacturer AddressWOERMANNKEHRE 1 BERLIN 12359 12359


Patients

Patient NumberTreatmentOutcomeDate
101. Hospitalization 2015-11-11

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