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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: RICE CREEK MFG MEDTRONIC CABLE; PULSE-GENERATOR, PACEMAKER, EXTERNAL

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RICE CREEK MFG MEDTRONIC CABLE; PULSE-GENERATOR, PACEMAKER, EXTERNAL Back to Search Results
Model Number MDT-CABLE
Device Problem Material Integrity Problem (2978)
Patient Problems Arrhythmia (1721); Bradycardia (1751)
Event Date 01/01/2019
Event Type  Death  
Manufacturer Narrative
If information is provided in the future, a supplemental report will be issued.
 
Event Description
It was reported that external pulse generators (epgs) were directly related to patients experiencing bradycardia and fibrillation.It was further reported that these events were related to the device (epg) settings, epg connection issues and external epg cabling issues.The current status of the epgs is unknown.It was indicated that the events led to patient death.There is no additional information available.
 
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Brand Name
MEDTRONIC CABLE
Type of Device
PULSE-GENERATOR, PACEMAKER, EXTERNAL
Manufacturer (Section D)
RICE CREEK MFG
7000 central ave ne
fridley MN 55432
Manufacturer (Section G)
RICE CREEK MFG
7000 central ave ne
fridley MN 55432
Manufacturer Contact
paula bixby
8200 coral sea st ne
mounds view, MN 55112
7635055378
MDR Report Key8746709
MDR Text Key149615491
Report Number6000030-2019-00064
Device Sequence Number1
Product Code DTE
Combination Product (y/n)N
Reporter Country CodeUK
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type foreign,health professional
Reporter Occupation Physician
Type of Report Initial
Report Date 06/28/2019
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received06/29/2019
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberMDT-CABLE
Device Catalogue NumberMDT-CABLE
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received05/31/2019
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
Patient Outcome(s) Death;
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