FDA Adverse Event Injury Summary report: N

TENDRIL SDX

MDR report key: 1073299 · Received July 11, 2008

Report

Report Number
2017865-2008-02098
Event Type
Injury
Date Received
July 11, 2008
Date of Event
May 6, 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
WI
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

SUBCLAVIAN CRUSH WAS REPORTED. THE VENTRICULAR OUTPUT WAS SET TO 3.5 V, 0.4 MS IN UNIPOLAR. THE LEAD WAS SUBSEQUENTLY REPLACED.

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 1488TC/52 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention