FDA Adverse Event Injury Summary report: N

TENDRIL SDX

MDR report key: 1073412 · Received July 11, 2008

Report

Report Number
2017865-2008-01977
Event Type
Injury
Date Received
July 11, 2008
Date of Event
April 10, 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
OH
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

IT WAS REPORTED THAT THE PATIENT RECEIVED INAPPROPRIATE THERAPY DUE TO NOISE ON THE LEAD. THE NOISE APPEARED TO BE CONSISTENT WITH AN INNER CONDUCTOR FRACTURE. THE LEAD WAS CAPPED AND 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 1688TC/58 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention