MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-10-17 for MEDTRONIC DUAL CHAMBER TEMPORARY PACEMAKER 5388 manufactured by Medtronic.
| Report Number | 9203102 |
| MDR Report Key | 9203102 |
| Date Received | 2019-10-17 |
| Date of Report | 2019-10-03 |
| Date of Event | 2019-09-26 |
| Date Facility Aware | 2016-09-26 |
| Report Date | 2019-10-03 |
| Date Reported to FDA | 2019-10-09 |
| Date Reported to Mfgr | 2019-10-09 |
| Date Added to Maude | 2019-10-17 |
| 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 | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | MEDTRONIC DUAL CHAMBER TEMPORARY PACEMAKER |
| Generic Name | TEMPORARY PACEMAKER |
| Product Code | LDF |
| Date Received | 2019-10-17 |
| Model Number | 5388 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Age | 150 MO |
| Device Eval'ed by Mfgr | I |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MEDTRONIC |
| Manufacturer Address | MINNEAPOLIS MN 554325604 US 554325604 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2019-10-17 |