FDA Adverse Event
Injury
Summary report: N
TENDRIL ST
MDR report key: 1050856
·
Received May 27, 2008
Report
- Report Number
- 2017865-2008-01308
- Event Type
- Injury
- Date Received
- May 27, 2008
- Date of Event
- February 12, 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
- TX
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
Narratives
Additional Manufacturer Narrative · 1
NO MEDWATCH FORM WAS RECEIVED. DEVICE EVALUATION ANTICIPATED BUT NOT YET BEGUN.
Description of Event or Problem · 1
IT WAS REPORTED THAT POST IMPLANT, THE LEAD EXHIBITED INTER- MITTENT LOSS OF VENTRICULAR CAPTURE. THE PATIENT PRESENTED TO THE HOSPITAL WITH SYNCOPAL SYMPTOMS. PERICARDIAL EFFUSION WAS OBSERVED VIA ECHOCARDIOGRAM. THE POCKET WAS RE- OPENED AND SUBSEQUENT FLUOROSCOPY REVEALED PERFORATION OF THE RIGHT VENTRICLE. THEREFORE, THE LEAD WAS REPLACED. THE PATIENT HAD A HISTORY OF COMPLETE HEART BLOCK AND WILL BE CLINICALLY MONITORED.
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 |