FDA Adverse Event Injury Summary report: N

TENDRIL ST

MDR report key: 1050631 · Received May 27, 2008

Report

Report Number
2017865-2008-01598
Event Type
Injury
Date Received
May 27, 2008
Date of Event
January 2, 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
IL
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 POST IMPLANT, THE PATIENT EXPERIENCED DIAPHRAGMATIC STIMULATION. IT WAS RESOLVED WITH AUTOCAPTURE TURNED OFF AND BIPOLAR PACING. THE PATIENT CONTINUED TO FEEL STIMULATION DESPITE ATTEMPTS TO PACE AT LOWER OUTPUTS. AN X-RAY CONFIRMED LEAD DISLODGEMENT OF BOTH LEADS. THE SUTURE AT TIEDOWN WAS LOST. THE LEADS WERE REPOSITIONED WITH NO FURTHER CONCERNS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TENDRIL ST PERMANENT PACEMAKER ELECTRODE DTB ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 1888TC/52 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention