| Brand Name | NCP PULSE GENERATOR |
| Type of Device | PULSE GENERATOR |
| Manufacturer (Section D) |
| CYBERONICS, INC. |
| 16511 space center blvd. |
| ste. 600 |
| houston TX 77058 |
|
| Manufacturer Contact |
|
darlene
garner, rac
|
| 16511 space center blvd. |
| ste. 600 |
| houston
, TX 77058 |
| (281)
228
-7200
|
|
| Device Event Key | 387192 |
| MDR Report Key | 398141 |
| Event Key | 376231 |
| Report Number | 1644487-2002-00255 |
| Device Sequence Number | 1 |
| Product Code | LYJ |
| Report Source |
Manufacturer
|
| Source Type |
Consumer
|
| Reporter Occupation |
Patient
|
| Type of Report
| Initial |
| Report Date |
05/08/2002 |
| 1 Device Was Involved in the Event | |
| 1 Patient Was Involved in the Event | |
| Date FDA Received | 06/04/2002 |
| Is This An Adverse Event Report? |
Yes
|
| Is This A Product Problem Report? |
No
|
| Device Operator |
Health Professional
|
| Was Device Available For Evaluation? |
No
|
| Is The Reporter A Health Professional? |
No
|
| Was the Report Sent to FDA? |
No
|
| Date Manufacturer Received | 05/08/2002 |
| Was Device Evaluated By Manufacturer? |
Device Not Returned To Manufacturer
|
| Is The Device Single Use? |
Yes
|
| Is the Device an Implant? |
Yes
|
| Is this an Explanted Device? |
|
| Type of Device Usage |
Initial
|
| Patient TREATMENT DATA |
| Date Received: 06/04/2002 Patient Sequence Number: 1 |
| # | Treatment | Treatment Date |
| 1,MODEL 300 NCP BIPOLAR LEAD, S/N UNKNOWN. |
|
|
|