FDA Adverse Event
Malfunction
Summary report: N
TENDRIL SDX
MDR report key: 3924132
·
Received July 9, 2014
Report
- Report Number
- 2017865-2014-15067
- Event Type
- Malfunction
- Date Received
- July 9, 2014
- Date of Event
- May 23, 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
- MA, 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 VIA A MERLIN.NET TRANSMISSION, THE ATRIAL LEAD EXHIBITED NOISE. THE NOISE WAS NOT REPRODUCIBLE THROUGH ISOMETRICS. THE LEAD REMAINED IMPLANTED AND THE PATIENT WOULD CONTINUE TO BE MONITORED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 400277 | TENDRIL SDX | PERMANENT PACEMAKER ELECTRODE | NVN | ST. JUDE MEDICAL, INC., CRMD | 1688TC/46 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 77 YR | (B)(4), 3211-, 556441 |