FDA Adverse Event Malfunction Summary report: N

TENDRIL ST

MDR report key: 3923312 · Received July 9, 2014

Report

Report Number
2017865-2014-14588
Event Type
Malfunction
Date Received
July 9, 2014
Date of Event
May 12, 2014
Manufacturer
ST. JUDE MEDICAL, INC., CRMD
Product Code
NVN
PMA / PMN Number
NA
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT REPRODUCIBLE NOISE WAS SEEN ON THE RIGHT VENTRICULAR LEAD OF AN ASYMPTOMATIC PATIENT. THE LEAD WOULD BE MONITORED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
401177 TENDRIL ST PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, INC., CRMD 1888TC/52 NA

Patients

Seq Age Sex Outcome Treatment
1 93 YR (B)(4)