FDA Adverse Event Injury Summary report: N

TENDRIL SDX

MDR report key: 3924139 · Received July 9, 2014

Report

Report Number
2017865-2014-15095
Event Type
Injury
Date Received
July 9, 2014
Date of Event
April 17, 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
SC, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT THE RIGHT VENTRICULAR LEAD EXHIBITED HIGH THRESHOLD. THE LEAD WAS CAPPED AND REPLACED. THE PATIENT WAS DOING WELL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
400321 TENDRIL SDX PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, INC., CRMD 1688TC/52 NA

Patients

Seq Age Sex Outcome Treatment
1 75 YR Required Intervention