FDA Adverse Event Malfunction Summary report: N

TENDRIL SDX

MDR report key: 1896425 · Received November 10, 2010

Report

Report Number
2017865-2010-04974
Event Type
Malfunction
Date Received
November 10, 2010
Date of Event
August 24, 2010
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
DTB
PMA / PMN Number
P960013
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AL
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 REVIEW OF THE REMOTE MONITORING TEST REVEALED 100 OHMS ATRIAL LEAD IMPEDANCE AND NOISE ON THE EGMS. THE LEAD WOULD BE MONITORED.

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 69 YR