FDA Adverse Event Malfunction Summary report: N

TENDRIL DX

MDR report key: 1955801 · Received January 10, 2011

Report

Report Number
2017865-2011-00699
Event Type
Malfunction
Date Received
January 10, 2011
Date of Event
November 9, 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
MA
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 A LOW UNIPOLAR IMPEDANCE OF 211 OHMS; THE IMPEDANCE HAD BEEN DECREASING SINCE 2006. LEAD PROGRAMMING WAS SWITCHED TO BIPOLAR, WHERE IMPEDANCE WAS 258 OHMS.

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 1388TC/58 NA

Patients

Seq Age Sex Outcome Treatment
1 90 YR