FDA Adverse Event
Malfunction
Summary report: N
TENDRIL SDX
MDR report key: 3926140
·
Received July 10, 2014
Report
- Report Number
- 2017865-2014-15471
- Event Type
- Malfunction
- Date Received
- July 10, 2014
- Date of Event
- April 2, 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 Location
- WA, US
- Reporter Occupation
- OTHER
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 NOISE WAS OBSERVED ON THE ASYMPTOMATIC PATIENTS ATRIAL LEAD THROUGH REMOTE REVIEW. PLANS WERE MADE TO BRING THE PATIENT IN FOR A DEVICE REPROGRAMMING.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 403247 | TENDRIL SDX | PERMANENT PACEMAKER ELECTRODE | NVN | ST. JUDE MEDICAL, INC., CRMD | 1688TC/46 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 83 YR |