FDA Adverse Event Injury Summary report: N

TENDRIL ST

MDR report key: 1073433 · Received July 11, 2008

Report

Report Number
2017865-2008-02217
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 Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

NO MEDWATCH FORM WAS RECEIVED. FINAL ANALYSIS FOUND THAT TOO MANY REVOLUTIONS HAD BEEN APPLIED WHILE EXTENDING THE HELIX, CAUSING OVER TORQUE OF THE DISTAL COIL. THIS RESULTED IN THE DISTAL COIL COLLAPSING, WHICH DAMAGED THE DISTAL INSULATION AND CAUSED THE LEAD COILS TO SHORT CIRCUIT.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE LEAD EXHIBITED LOW SENSING, HIGH CAPTURE THRESHOLDS, AND IMPEDANCE OF LESS THAN 200 OHMS. THE LEAD WAS 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 1788TC/58 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention