FDA Adverse Event Injury Summary report: N

TENDRIL SDX

MDR report key: 1050596 · Received May 27, 2008

Report

Report Number
2017865-2008-01563
Event Type
Injury
Date Received
May 27, 2008
Date of Event
March 28, 2008
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
DTB
PMA / PMN Number
PMA00001
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE LEAD WAS FRACTURED. THE LEAD WAS PINNED BETWEEN THE PULSE GENERATOR AND RIBS. THE PRESSURE FROM THE PULSE GENERATOR SHIFTING CAUSED THE LEAD TO BE PINCHED AND TO FRACTURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TENDRIL SDX PERMANENT PACEMAKER ELECTRODE DTB ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 1688TC/52 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention