ACCENT DR RF PACEMAKER PM2210

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2019-11-30 for ACCENT DR RF PACEMAKER PM2210 manufactured by St. Jude Medical, Inc.(crm-sunnyvale).

MAUDE Entry Details

Report Number2938836-2019-16772
MDR Report Key9392521
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2019-11-30
Date of Report2019-11-30
Date of Event2019-11-11
Date Mfgr Received2019-11-11
Device Manufacturer Date2013-09-24
Date Added to Maude2019-11-30
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 ContactELIZABETH BOLTZ
Manufacturer Street15900 VALLEY VIEW COURT
Manufacturer CitySYLMAR CA 91342
Manufacturer CountryUS
Manufacturer Postal91342
Manufacturer G1ST. JUDE MEDICAL, INC.(CRM-SUNNYVALE)
Manufacturer Street645 ALMANOR AVENUE
Manufacturer CitySUNNYVALE CA 94085
Manufacturer CountryUS
Manufacturer Postal Code94085
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameACCENT DR RF PACEMAKER
Generic NameIMPLANTABLE PACEMAKER PULSE GENERATOR
Product CodeNVZ
Date Received2019-11-30
Returned To Mfg2019-11-18
Model NumberPM2210
Lot Number4261105
Device Expiration Date2015-03-31
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerST. JUDE MEDICAL, INC.(CRM-SUNNYVALE)
Manufacturer Address645 ALMANOR AVENUE SUNNYVALE CA 94085 US 94085


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2019-11-30

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