FDA Adverse Event Injury Summary report: N

TENDRIL ST

MDR report key: 2240083 · Received September 9, 2011

Report

Report Number
2017865-2011-05705
Event Type
Injury
Date Received
September 9, 2011
Date of Event
July 13, 2011
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
NVN
PMA / PMN Number
NA
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

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT EXPERIENCED PLEURAL EFFUSION AND DID NOT FEEL WELL. THE LEAD HAD PERFORATED THE RIGHT ATRIUM. THE LEAD WAS REPLACED BUT THE PATIENT REMAINED UNDER INTENSIVE CARE AND -NOT WELL-.

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/52 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention