FDA Adverse Event Malfunction Summary report: N

TENDRIL SDX

MDR report key: 2240430 · Received September 9, 2011

Report

Report Number
2017865-2011-05537
Event Type
Malfunction
Date Received
September 9, 2011
Date of Event
June 8, 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 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 DURING A DEVICE CHANGE OUT, THE LEAD EXHIBITED A HIGH THRESHOLD OF 4.5 V, 1.0 MS AND A HIGH IMPEDANCE OF 3321 OHMS IN THE BIPOLAR CONFIGURATION. THE LEAD WAS CAPPED.

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 1688T/52 NA

Patients

Seq Age Sex Outcome Treatment
1