MAUDE MDR 9392003

MDR report key
9392003
Report number
2938836-2019-16756
Event key
0
Event type
3
Date received
2019-11-29
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
3
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
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1TENDRIL SDX LEADPERMANENT PACEMAKER ELECTRODEST. JUDE MEDICAL, INC.(CRM-SUNNYVALE)NVN1688TC/520002112699Y R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-11-290

Event Narratives#

No narrative records found.