FDA Adverse Event Injury Summary report: N

TENDRIL ST

MDR report key: 3923315 · Received July 9, 2014

Report

Report Number
2017865-2014-14598
Event Type
Injury
Date Received
July 9, 2014
Date of Event
April 28, 2014
Manufacturer
ST. JUDE MEDICAL, INC., CRMD
Product Code
NVN
PMA / PMN Number
NA
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT THE VENTRICULAR LEAD EXHIBITED LOW IMPEDANCE. THE LEAD WAS CAPPED AND REPLACED. FOLLOWING THE EVENT, THE PATIENT WAS IN GOOD CONDITION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
401189 TENDRIL ST PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, INC., CRMD 1888TC/58 NA

Patients

Seq Age Sex Outcome Treatment
1 71 YR Required Intervention