FDA Adverse Event Death Summary report: N

TENDRIL STS

MDR report key: 3914403 · Received July 3, 2014

Report

Report Number
2017865-2014-14000
Event Type
Death
Date Received
July 3, 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
NE, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT HAS DECEASED. THERE IS NO ALLEGATION FROM A HEALTH CARE PROFESSIONAL THAT SUGGESTS THAT THE DEATH WAS DEVICE RELATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
390063 TENDRIL STS PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, INC., CRMD 2088TC/52 NA

Patients

Seq Age Sex Outcome Treatment
1 Death (B)(4)