FDA Adverse Event Malfunction Summary report: N

TENDRIL DX

MDR report key: 1050525 · Received May 27, 2008

Report

Report Number
2017865-2008-01501
Event Type
Malfunction
Date Received
May 27, 2008
Date of Event
March 1, 2008
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
DXY
PMA / PMN Number
PMA00001
Removal / Correction Number
NA
Report Source
Manufacturer report
Reporter Location
WI
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

NO MEDWATCH FORM WAS RECEIVED.

Description of Event or Problem · 1

IT WAS REPORTED THAT NOISE WAS OBSERVED ON THE EGM'S. ARM EXERCISES REPRODUCED INHIBITION AND NOISE ON THE SURFACE ECG'S. HIGH CAPTURE THRESHOLDS WERE NOTED IN THE BIPOLAR CONFIGURATION. LEAD IMPEDANCES WERE NORMAL TO HIGH.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TENDRIL DX PERMANENT PACEMAKER ELECTRODE DXY ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 1388TC/52 NA

Patients

Seq Age Sex Outcome Treatment
1