BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    TENDRIL ST

    MDR report key: 3923376 · Received July 9, 2014

    Report

    Report Number
    2017865-2014-14659
    Event Type
    Malfunction
    Date Received
    July 9, 2014
    Date of Event
    May 6, 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
    CA, US
    Reporter Occupation
    NURSE

    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 LOW LEVELS OF NOISE WERE OBSERVED ON THE ASYMPTOMATIC PATIENTS ATRIAL LEAD. THE NOISE COULD BE REPRODUCED THROUGH ISOMETRIC EXERCISES. THE PATIENT DID NOT HAVE AN ACTIVE CARDIOLOGIST AT THE TIME. THE CLINICIAN WOULD PLAN A COURSE OF ACTION ONCE A PHYSICIAN WAS CHOSEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    401829 TENDRIL ST PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, INC., CRMD 1882TC/46 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 80 YR