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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BIOTRONIK SE & CO. KG PLEXA PROMRI SD 65/18; ICD LEAD

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BIOTRONIK SE & CO. KG PLEXA PROMRI SD 65/18; ICD LEAD Back to Search Results
Model Number 402263
Medical Device Problem Codes Fracture (1260); Impedance Problem (2950)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/12/2026
Type of Reportable Event Serious Injury
Event or Problem Description
This rv lead was capped due to elevated impedance indicating a fracture.No adverse patient events were reported.Should additional information be received this file will be updated.
 
Additional Manufacturer Narrative
Combination product: yes.
 
Additional Manufacturer Narrative
Combination product: yes.The lead is currently not available for analysis.No conclusion can be drawn based on available information at the moment.The file is closed.The investigation will be re-opened should additional data become available.
 
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Brand Name
PLEXA PROMRI SD 65/18
Common Device Name
ICD LEAD
Manufacturer (Section D)
BIOTRONIK SE & CO. KG
woermannkehre 1
berlin 12359
Manufacturer Contact
6024 jean road
lake oswego, OR 97035
8772459800
MDR Report Key24413703
Report Number1028232-2026-00897
Device Sequence Number12246984
Product Code NVY
UDI-Device Identifier04035479139995
UDI-Public(01)04035479139995(17)211130
Combination Product (Y/N)Y
Initial Reporter StateSC
Initial Reporter CountryUS
PMA/510(K) Number
P980023
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2020
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 02/25/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Expiration Date11/30/2021
Device Model Number402263
Device Catalogue Number402263
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/20/2026
Supplement Date Received by Manufacturer02/24/2026
Initial Report FDA Received Date02/23/2026
Supplement Report FDA Received Date02/25/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured11/13/2019
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Outcome Attributed to Adverse Event Required Intervention; Hospitalization;
Patient Age83 YR
Patient SexUnknown
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