FDA Adverse Event
Malfunction
Summary report: N
TENDRIL STS
MDR report key: 3924083
·
Received July 9, 2014
Report
- Report Number
- 2017865-2014-15010
- Event Type
- Malfunction
- Date Received
- July 9, 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
- FR
- Reporter Occupation
- OTHER
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 DURING IMPLANT, THE LEAD EXHIBITED UNACCEPTABLE THRESHOLDS AT MULTIPLE SITES. DURING ATTEMPTS TO REPOSITION THE LEAD, THE HELIX WOULD NOT EXTEND OR RETRACT. THE LEAD WAS NOT USED AND A NEW LEAD WAS IMPLANTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 399431 | TENDRIL STS | PERMANENT PACEMAKER ELECTRODE | NVN | ST. JUDE MEDICAL, INC., CRMD | 2088TC/58 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |