FDA Adverse Event Malfunction Summary report: N

TENDRIL SDX

MDR report key: 1955708 · Received January 10, 2011

Report

Report Number
2017865-2011-00825
Event Type
Malfunction
Date Received
January 10, 2011
Date of Event
November 10, 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
PA
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 VENTRICULAR LEAD EXHIBITED LESS THAN 200 OHMS BIPOLAR IMPEDANCE AND 215 OHMS UNIPOLAR IMPEDANCE. PROGRAMMING WAS LEFT IN UNIPOLAR AND THE PATIENT 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 1688TC/58 NA

Patients

Seq Age Sex Outcome Treatment
1 76 YR