FDA Adverse Event Injury Summary report: N

TENDRIL SDX

MDR report key: 1223484 · Received November 10, 2008

Report

Report Number
2017865-2008-03224
Event Type
Injury
Date Received
November 10, 2008
Date of Event
August 7, 2008
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
DTB
PMA / PMN Number
NA
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

FINAL ANALYSIS FOUND BOTH THE PROXIMAL AND DISTAL INSULATIONS DAMAGED AT 23 CM FROM THE CONNECTOR PIN DUE TO CLAVICULAR CRUSH.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE LEAD WAS DEFECTIVE.

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