FDA Adverse Event Injury Summary report: N

TENDRIL SDX

MDR report key: 2014192 · Received March 10, 2011

Report

Report Number
2017865-2011-01449
Event Type
Injury
Date Received
March 10, 2011
Date of Event
January 24, 2011
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
NVN
PMA / PMN Number
P960013
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(6).

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 PERFORATED THE RIGHT VENTRICLE. THERE WAS NO STIMULATION IN THE VENTRICLE DUE TO THE LEAD BEING IN THE PERICARDIUM. THE LEAD WAS EXTRACTED WITHOUT PROBLEM AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TENDRIL SDX PERMANENT PACEMAKER ELECTRODE NVN ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 1688TC/58 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention