FDA Adverse Event Injury Summary report: N

TENDRIL ST

MDR report key: 3923326 · Received July 9, 2014

Report

Report Number
2017865-2014-14609
Event Type
Injury
Date Received
July 9, 2014
Date of Event
May 15, 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
NC, US
Reporter Occupation
PHYSICIAN

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 RIGHT ATRIAL LEAD EXHIBITED LOW IMPEDANCE. THE LEAD WAS CAPPED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
402149 TENDRIL ST PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, INC., CRMD 1888TC/46 NA

Patients

Seq Age Sex Outcome Treatment
1 81 YR Required Intervention 1888TC/52, BCK20963