Brand Name | ENCOR |
Type of Device | PERM IMPL PACER ELECTRODE |
Manufacturer (Section D) |
TELECTRONICS PACING SYSTEMS, INC. |
14520 northwest 60th ave |
miami lakes FL 33014 |
|
Manufacturer Contact |
cindy
hazen
|
17011 lincoln ave |
parker, CO 80134-8815
|
3036458033
|
|
MDR Report Key | 4107126 |
MDR Text Key | 4836372 |
Report Number | 1723248-2014-00013 |
Device Sequence Number | 1 |
Product Code |
DTB
|
Combination Product (y/n) | N |
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Health Professional |
Reporter Occupation |
No Information
|
Remedial Action |
Recall |
Type of Report
| Initial |
Report Date |
09/03/2014 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 09/05/2014 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Device Operator |
Other
|
Device Model Number | 327-752 |
Device Catalogue Number | 0327752 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
No
|
Device Age | 372 MO |
Event Location |
Hospital
|
Date Manufacturer Received | 09/02/2014 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Is the Device Single Use? |
Yes
|
Type of Device Usage |
Initial
|
Removal/Correction Number | Z-1771/1772/5 |
Patient Sequence Number | 1 |
Patient Outcome(s) |
Other;
|
|
|