FDA Adverse Event Injury Summary report: N

TENDRIL SDX

MDR report key: 2014205 · Received March 10, 2011

Report

Report Number
2017865-2011-01388
Event Type
Injury
Date Received
March 10, 2011
Date of Event
December 6, 2010
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
DTB
PMA / PMN Number
P960013
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AZ
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 HIGH ATRIAL THRESHOLDS. THE LEAD WAS REPLACED.

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/46 NA

Patients

Seq Age Sex Outcome Treatment
1 80 YR Required Intervention