FDA Adverse Event Injury Summary report: N

TENDRIL SDX

MDR report key: 2240461 · Received September 9, 2011

Report

Report Number
2017865-2011-05550
Event Type
Injury
Date Received
September 9, 2011
Date of Event
June 20, 2011
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
NVN
PMA / PMN Number
P960013
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED. OTHER TEXT: DEVICE EVALUATION ANTICIPATED, BUT NOT YET BEGUN.

Additional Manufacturer Narrative · 1

FINAL ANALYSIS FOUND THAT PARTIAL LEAD WAS RETURNED IN SEVEN PIECES. THE LEAD BODY ON ONE PORTION APPEARED TO BE ABRADED/DAMAGED DUE TO CLAVICULAR CRUSH, BREACHING THE PROXIMAL AND DISTAL INSULATIONS. THIS WOULD ALLOW CONTACT BETWEEN THE COILS RESULTING IN LOW IMPEDANCE, NOISE AND OVERSENSING.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE RIGHT ATRIAL LEAD EXHIBITED LESS THAN 200 OHMS IMPEDANCE AND OVERSENSING. THE LEAD HAD CLAVICULAR CRUSH. THE LEAD WAS REMOVED AND REPLACED.

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 1688TC/46 NA

Patients

Seq Age Sex Outcome Treatment
1 75 YR Required Intervention (B)(4)