FDA Adverse Event Injury Summary report: N

TENDRIL SDX

MDR report key: 1223930 · Received November 10, 2008

Report

Report Number
2017865-2008-03379
Event Type
Injury
Date Received
November 10, 2008
Date of Event
September 4, 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
MS
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 LEAD EXHIBITED NO CAPTURE AND NO SENSING. IT WAS ALSO NOTED THAT THE LEAD PERFORATED INSIDE THE PERICARDIUM.

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/52 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention