FDA Adverse Event Injury Summary report: N

TENDRIL SDX

MDR report key: 2905288 · Received January 9, 2013

Report

Report Number
2017865-2013-00644
Event Type
Injury
Date Received
January 9, 2013
Date of Event
November 7, 2012
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
NVN
PMA / PMN Number
P960013
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

NO MEDWATCH FORM WAS RECEIVED.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING AN OPEN HEART PROCEDURE THE ATRIAL LEAD WAS PERFORATED. THE LEAD WAS SUCCESSFULLY REVISED. NO COMPLICATIONS WERE NOTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
11408 TENDRIL SDX PERMANENT PACEMAKER ELECTRODE NVN ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 1688TC/52 NA

Patients

Seq Age Sex Outcome Treatment
1 46 YR Required Intervention