FDA Adverse Event Injury Summary report: N

TENDRIL SDX

MDR report key: 3925802 · Received July 10, 2014

Report

Report Number
2017865-2014-15660
Event Type
Injury
Date Received
July 10, 2014
Date of Event
April 16, 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
FL, 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 THE ATRIAL LEAD EXHIBITED LOSS OF CAPTURE, OVERSENSING AND AN INSULATION ANOMALY. THE LEAD WAS CAPPED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
404549 TENDRIL SDX PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, INC., CRMD 1688TC/52 NA

Patients

Seq Age Sex Outcome Treatment
1 73 YR Required Intervention