FDA Adverse Event Injury Summary report: N

TENDRIL SDX

MDR report key: 3925817 · Received July 10, 2014

Report

Report Number
2017865-2014-15658
Event Type
Injury
Date Received
July 10, 2014
Date of Event
November 1, 2013
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
PA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED. FINAL ANALYSIS FOUND INSULATION ABRASION IN SUTURE SLEEVE TIE DOWN REGION AT 20.7 CM FROM THE CONNECTOR PIN; WHICH COULD HAVE CONTRIBUTED TO THE COMPLAINT DETECTED IN THE FIELD.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE RIGHT ATRIAL LEAD EXHIBITED LOW IMPEDANCE IN (B)(6) 2013. NOISE WAS NOTED ON THE LEAD AT SUBSEQUENT FOLLOW-UPS. THE NOISE WAS REPRODUCIBLE WITH ISOMETRICS. THE LEAD WAS EXPLANTED AND REPLACED ON (B)(6) 2014.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
404554 TENDRIL SDX PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, INC., CRMD 1688TC/52 NA

Patients

Seq Age Sex Outcome Treatment
1 57 YR Required Intervention