MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-10-18 for SMARTVIEW SMARTVIEW GPRS manufactured by Sorin Group Italia S.r.l. - Crm Facility.
[177171072]
Reportedly, on (b)(6) 2019, a report has been transmitted to the physician with the correct patient name, but the serial number of the implant displayed in the report corresponded to an implant from another patient that was previously associated to the subject home monitor (the home monitor was re-used by the physician).
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1000165971-2019-00582 |
| MDR Report Key | 9208751 |
| Date Received | 2019-10-18 |
| Date of Report | 2019-10-18 |
| Date of Event | 2019-09-20 |
| Date Facility Aware | 2019-09-25 |
| Date Mfgr Received | 2019-09-25 |
| Date Added to Maude | 2019-10-18 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | ELODIE VINCENT |
| Manufacturer Street | PARC D'AFFAIRES NOVEOS 4 AVENUE R . |
| Manufacturer City | CLAMART 92140 |
| Manufacturer Country | FR |
| Manufacturer Postal | 92140 |
| Manufacturer Phone | 0146013665 |
| Manufacturer G1 | EOLANE BLD J. BAPTISTE COLBERT 49520 COMBREE FRANCE |
| Manufacturer Street | PARC D'AFFAIRES NOVEOS 4 AVENUE R . |
| Manufacturer City | CLAMART 92140 |
| Manufacturer Country | FR |
| Manufacturer Postal Code | 92140 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | SMARTVIEW |
| Generic Name | PACEMAKER/ICD/CRT NON-IMPLANTED COMPONENTS |
| Product Code | OSR |
| Date Received | 2019-10-18 |
| Model Number | SMARTVIEW GPRS |
| Catalog Number | SMARTVIEW GPRS |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | SORIN GROUP ITALIA S.R.L. - CRM FACILITY |
| Manufacturer Address | PARC D'AFFAIRES NOVEOS 4 AVENUE R?AUMUR . CLAMART 92140 FR 92140 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-10-18 |