FDA Adverse Event Malfunction Summary report: N

TENDRIL DX

MDR report key: 1955795 · Received January 10, 2011

Report

Report Number
2017865-2011-00684
Event Type
Malfunction
Date Received
January 10, 2011
Date of Event
November 29, 2010
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
DTB
PMA / PMN Number
NA
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL
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 RIGHT ATRIAL LEAD EXHIBITED LOW IMPEDANCE OF 190 OHMS AND OVERSENSING, CAUSING MODE SWITCH EVENTS TO OCCUR. THE OVERSENSING COULD BE REPRODUCED IN CLINIC WITH ISOMETRIC EXERCISES. IT WAS SUSPECTED THAT THE OVERSENSING MAY BE DUE TO MYOPOTENTIALS SINCE BOTH OF THE PATIENT'S LEADS WERE UNIPOLAR LEADS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TENDRIL DX PERMANENT PACEMAKER ELECTRODE DTB ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 1388K/46 NA

Patients

Seq Age Sex Outcome Treatment
1 86 YR (B)(4)