FDA Adverse Event Malfunction Summary report: N

TENDRIL SDX

MDR report key: 2014002 · Received March 10, 2011

Report

Report Number
2017865-2011-01398
Event Type
Malfunction
Date Received
March 10, 2011
Date of Event
January 10, 2011
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
NH
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 UNDERSENSING DESPITE A SENSITIVITY OF 1.5 MV AND A R-WAVE MEASUREMENT OF 4 MV. THE VENTRICULAR AMPLITUDE TREND EXHIBITED A FLUCTUATION IN THE R-WAVE MEASUREMENTS FROM 3 MV TO GREATER THAN 12 MV.

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 1488TC/58 NA

Patients

Seq Age Sex Outcome Treatment
1 70 YR