FDA Adverse Event Malfunction Summary report: N

TENDRIL ST

MDR report key: 2083894 · Received May 11, 2011

Report

Report Number
2017865-2011-02838
Event Type
Malfunction
Date Received
May 11, 2011
Date of Event
March 1, 2011
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
NVN
PMA / PMN Number
P960013
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX
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 NOISE. THE P WAVES MEASURED BETWEEN 3.5 - 4.5 MV. THE SENSITIVITY SETTING OF THE SYSTEM WAS DECREASED. THE PATIENT WAS VERY SICK AND MAYBE PLACED ON A HEART TRANSPLANT LIST.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TENDRIL ST PERMANENT PACEMAKER ELECTRODE NVN ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 1888TC/46 NA

Patients

Seq Age Sex Outcome Treatment
1 54 YR