FDA Adverse Event Injury Summary report: N

TENDRIL STS

MDR report key: 3925644 · Received July 10, 2014

Report

Report Number
2017865-2014-15000
Event Type
Injury
Date Received
July 10, 2014
Date of Event
April 3, 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 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 THE ATRIAL LEAD EXHIBITED UNACCEPTABLE THRESHOLDS AND A SENSING ANOMALY. THE LEAD WAS EXPLANTED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
404241 TENDRIL STS PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, INC., CRMD 2088TC/52 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention