| Brand Name | NI |
| Type of Device | PULSE GENERATOR |
| Manufacturer (Section D) |
| CYBERONICS, INC. |
| houston TX * |
|
| Manufacturer Contact |
|
darlene
garner, rac
|
| 100 cyberonics blvd., ste. 600 |
| houston
, TX 77058 |
| (281)
228
-7200
|
|
| Device Event Key | 633234 |
| MDR Report Key | 643726 |
| Event Key | 612221 |
| Report Number | 1644487-2005-00733 |
| Device Sequence Number | 1 |
| Product Code | LYJ |
| Report Source |
Manufacturer
|
| Source Type |
Foreign,Study,Literature,Health Professional
|
| Reporter Occupation |
Physician
|
| Type of Report
| Initial,Followup |
| Report Date |
10/04/2005 |
| 1 Device Was Involved in the Event | |
| 1 Patient Was Involved in the Event | |
| Date FDA Received | 10/31/2005 |
| 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? |
Yes
|
| Was the Report Sent to FDA? |
No
|
| Date Manufacturer Received | 10/04/2005 |
| Was Device Evaluated By Manufacturer? |
Device Not Returned To Manufacturer
|
| Is The Device Single Use? |
Yes
|
| Is this a Reprocessed and Reused Single-Use Device? |
No
|
| Is the Device an Implant? |
Yes
|
| Is this an Explanted Device? |
|
| Type of Device Usage |
Initial
|
|
|