FDA Adverse Event Injury Summary report: N

TENDRIL STS

MDR report key: 2983794 · Received February 28, 2013

Report

Report Number
2017865-2013-01589
Event Type
Injury
Date Received
February 28, 2013
Date of Event
January 8, 2013
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
DTB
PMA / PMN Number
NA
Removal / Correction Number
NA
Adverse Event
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 EVENING FOLLOWING THE IMPLANT OF THE RIGHT VENTRICULAR LEAD, THE PATIENT COMPLAINED SHE WAS NOT FEELING WELL. THE PHYSICIAN REALIZED THE LEAD HAD PERFORATED THE PATIENT. A SUCCESSFUL REPOSITION WAS DONE. THE PATIENT WAS -OK- AFTER THE PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
88557 TENDRIL STS PERMANENT PACEMAKER ELECTRODE DTB ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 2088TC/58 NA

Patients

Seq Age Sex Outcome Treatment
1 97 YR Required Intervention