FDA Adverse Event Injury Summary report: N

TENDRIL SDX

MDR report key: 1223926 · Received November 10, 2008

Report

Report Number
2017865-2008-03385
Event Type
Injury
Date Received
November 10, 2008
Date of Event
September 19, 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

NA

Description of Event or Problem · 1

IT WAS REPORTED THAT THE LEAD EXHIBITED LOSS OF CAPTURE AND GREATER THAN 2500 OHMS IMPEDANCE IN BOTH UNIPOLAR AND BIPOLAR PACING CONFIGURATIONS. THE LEAD WAS 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