FDA Adverse Event Injury Summary report: N

TENDRIL ST

MDR report key: 1073209 · Received July 11, 2008

Report

Report Number
2017865-2008-02022
Event Type
Injury
Date Received
July 11, 2008
Date of Event
May 9, 2008
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
DTB
PMA / PMN Number
PMA00001
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NE
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

FINAL ANALYSIS FOUND AN ABRASION ON THE PROXIMAL INSULATION AT 20.1 CM FROM THE CONNECTOR PIN EXPOSING THE PROXIMAL COIL TO FRICTION WITH THE CAN. THIS WOULD CAUSE THE REPORTED PROBLEMS.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE LEAD EXHIBITED NOISE AND A SENSING ANOMALY.

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