FDA Adverse Event Malfunction Summary report: N

TENDRIL SDX

MDR report key: 3925818 · Received July 10, 2014

Report

Report Number
2017865-2014-15659
Event Type
Malfunction
Date Received
July 10, 2014
Date of Event
April 11, 2014
Manufacturer
ST. JUDE MEDICAL, INC., CRMD
Product Code
NVN
PMA / PMN Number
NA
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED. NO COMPLAINT RECEIVED WITH RETURN OF DEVICE. FAILURE EVENT OBSERVED DURING ANALYSIS. FINAL ANALYSIS FOUND THAT A PARTIAL LEAD WAS RETURNED. THE LEAD INSULATION WAS ABRADED AT 3.3 CM TO 4.3 CM FROM THE CONNECTOR PIN WHICH EXPOSED THE COIL. THE ABRASION WAS CONSISTENT WITH EXPOSURE TO CONSTANT FRICTION WITH ANOTHER IMPLANTABLE DEVICE. RELIABILITY LABORATORY TECHNICIAN RELIABILITY LABORATORY TECHNICIAN ST. JUDE MEDICAL CRMD RELIABILITY LABORATORY

Description of Event or Problem · 1

THIS REPORT IS TO ADVISE OF AN EVENT OBSERVED DURING ANALYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
405008 TENDRIL SDX PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, INC., CRMD 1688TC/52 NA

Patients

Seq Age Sex Outcome Treatment
1