FDA Adverse Event Injury Summary report: N

TENDRIL SDX

MDR report key: 1223827 · Received November 10, 2008

Report

Report Number
2017865-2008-03461
Event Type
Injury
Date Received
November 10, 2008
Date of Event
September 8, 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
MI
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

FINAL ANALYSIS FOUND THAT THE LEAD OUTER INSULATION WAS DAMAGED, DUE TO CLAVICULAR CRUSH AT 30 CM FROM THE DISTAL TIP ELECTRODE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE VENTRICULAR LEAD EXHIBITED INTERMITTENT LOSS OF CAPTURE. LEAD IMPEDANCE WAS LESS THAN 200 OHMS. MUSCLE STIMULATION WAS ALSO NOTED.

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 1688T/52 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention