FDA Adverse Event
Malfunction
Summary report: N
TENDRIL SDX
MDR report key: 3926151
·
Received July 10, 2014
Report
- Report Number
- 2017865-2014-15478
- Event Type
- Malfunction
- Date Received
- July 10, 2014
- Date of Event
- April 17, 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. FAILURE EVENT OBSERVED DURING ANALYSIS. FINAL ANALYSIS FOUND INSULATION ABRASION AT 12.7 CM TO 13.2 CM FROM THE CONNECTOR PIN. THE ABRASION IS CONSISTENT WITH THAT OF EXPOSURE TO FRICTION WITH ANOTHER IMPLANTABLE DEVICE. (B)(4). (B)(6).
Description of Event or Problem · 1
IT WAS REPORTED THAT THERE WAS A COMPLAINT OF NOISE IN 2009. ANALYSIS SHOWED MALFUNCTION ON THE LEAD UPON RETURN.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 403265 | TENDRIL SDX | PERMANENT PACEMAKER ELECTRODE | NVN | ST. JUDE MEDICAL, INC., CRMD | 1688TC/46 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |