FDA Adverse Event Injury Summary report: N

TENDRIL SDX

MDR report key: 3924173 · Received July 9, 2014

Report

Report Number
2017865-2014-15094
Event Type
Injury
Date Received
July 9, 2014
Date of Event
February 12, 2012
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

Description of Event or Problem · 1

IT WAS REPORTED THAT THE RIGHT VENTRICULAR LEAD EXHIBITED NOISE. THE LEAD WAS CAPPED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
399735 TENDRIL SDX PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, INC., CRMD 1688TC/52 NA

Patients

Seq Age Sex Outcome Treatment
1 67 YR Required Intervention 1688TC/52, DN235787