FDA Adverse Event Injury Summary report: N

TENDRIL ST

MDR report key: 3951260 · Received July 22, 2014

Report

Report Number
2017865-2014-02380
Event Type
Injury
Date Received
July 22, 2014
Date of Event
November 14, 2011
Manufacturer
ST. JUDE MEDICAL, CARDIAC RHYTHM MANAGEMENT DIVISI
Product Code
DTB
PMA / PMN Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS HISTORICAL COMPLAINT IS BEING FILED AS PART OF A RETROSPECTIVE REVIEW OF COMPLAINT FILES IN RESPONSE TO A RECENT FDA INSPECTION. THERE IS NO CHANGE TO THE ACTUAL PERFORMANCE OF THE PRODUCT AND THIS REPORT ONLY REPRESENTS AN ENHANCEMENT TO THE REPORTING CRITERIA GOING FORWARD.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE ATRIAL LEAD EXHIBITED NOISE WITH OVERSENSING. IT WAS CLINICALLY RESOLVED BY REPROGRAMMING. THE DEVICE REMAINED IMPLANTED.

Description of Event or Problem · 1

NEW INFORMATION INDICATES THE LEAD CONTINUES TO EXHIBIT OVERSENSING. THE LEAD WAS CAPPED AND REPLACED ON (B)(4) 2014.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
428192 TENDRIL ST DTB ST. JUDE MEDICAL, CARDIAC RHYTHM MANAGEMENT DIVISI 1888TC/52

Patients

Seq Age Sex Outcome Treatment
1 65 YR Required Intervention