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 |