FDA Adverse Event
Injury
Summary report: N
TENDRIL SDX
MDR report key: 3802549
·
Received May 9, 2014
Report
- Report Number
- 2017865-2014-13777
- Event Type
- Injury
- Date Received
- May 9, 2014
- Date of Event
- March 24, 2014
- Manufacturer
- ST. JUDE MEDICAL, INC., CRMD
- Product Code
- NVN
- PMA / PMN Number
- NA
- Removal / Correction Number
- NA
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- KY, US
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED. DEVICE EVALUATION ANTICIPATED, BUT NOT YET BEGUN.
Description of Event or Problem · 1
IT WAS REPORTED THAT DURING A LEAD REVISION PROCEDURE, THE PATIENT DEVELOPED A PNEUMOTHORAX. THE PHYSICIAN PERFORMED A THORACOTOMY, A CHEST TUBE WAS INSERTED. THE PATIENT WAS MONITORED OVERNIGHT AND WAS IN STABLE CONDITION.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 281347 | TENDRIL SDX | PERMANENT PACEMAKER ELECTRODE | NVN | ST. JUDE MEDICAL, INC., CRMD | 1488TC/52 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 69 YR | Required Intervention | (B)(4) |