BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TENDRIL ST

    MDR report key: 1073240 · Received July 11, 2008

    Report

    Report Number
    2017865-2008-02044
    Event Type
    Injury
    Date Received
    July 11, 2008
    Date of Event
    February 4, 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 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

    THE PATIENT WAS ADMITTED TO THE HOSPITAL WITH SYNCOPE. IT WAS REPORTED THAT BOTH LEADS DISLODGED AND NO "SCREW TIP" WAS VISIBLE. REPOSITIONING WAS UNSUCCESSFUL. THE LEADS WERE SUBSEQUENTLY REPLACED.

    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 1788T/58 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention