FDA Adverse Event Injury Summary report: N

TENDRIL DX

MDR report key: 1073313 · Received July 11, 2008

Report

Report Number
2017865-2008-02107
Event Type
Injury
Date Received
July 11, 2008
Date of Event
April 25, 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

NO MEDWATCH FORM WAS RECEIVED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE ATRIAL LEAD EXHIBITED HIGH CAPTURE THRESHOLDS, NO SENSING AND GREATER THAN 2000 OHMS IMPEDANCE. THE LEAD WAS SUBSEQUENTLY REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TENDRIL DX PERMANENT PACEMAKER ELECTRODE DTB ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 1388TC/46 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention