FDA Adverse Event
Malfunction
Summary report: N
TENDRIL SDX
MDR report key: 2905196
·
Received January 9, 2013
Report
- Report Number
- 2017865-2013-00608
- Event Type
- Malfunction
- Date Received
- January 9, 2013
- Date of Event
- November 20, 2012
- 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
RELIABILITY LABORATORY TECHNICIAN, NOT APPLICABLE - ST. JUDE MEDICAL (B)(4) RELIABILITY LABORATORY. NO COMPLAINT WAS RECEIVED WITH RETURN OF THE DEVICE. FAILURE (EVENT) OBSERVED DURING ANALYSIS. FINAL ANALYSIS FOUND THAT A PARTIAL LEAD WAS RETURNED. THE OUTER INSULATION WAS ABRADED AT 23.5 CM TO 25.0 CM FROM THE DISTAL TIP. ABRASIONS ARE INDICATIVE OF CONSTANT FRICTION WITH ANOTHER IMPLANTABLE DEVICE.
Description of Event or Problem · 1
THIS REPORT IS TO ADVISE OF AN EVENT OBSERVED DURING ANALYSIS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 10696 | TENDRIL SDX | PERMANENT PACEMAKER ELECTRODE | NVN | ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION | 1688T/52 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |