FDA.reportPublic FDA data

MAUDE MDR 9256728

MDR report key
9256728
Report number
2017865-2019-15719
Event key
0
Event type
3
Date of event
2019-10-17
Date received
2019-10-30
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
100
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
ELIZABETH BOLTZ
Address
15900 VALLEY VIEW COURT SYLMAR CA 91342 US
Phone
818-818-8184
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1MERLIN@HOME, RF TELEMETRY BASICPACEMAKER DATA TRANSMITTERST. JUDE MEDICAL, INC.(CRM-SYLMAR)DRGEX1150R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-10-300

Event Narratives#

No narrative records found.