FDA Adverse Event Injury Summary report: N

TENDRIL SDX

MDR report key: 4182217 · Received January 13, 2014

Report

Report Number
2017865-2014-03181
Event Type
Injury
Date Received
January 13, 2014
Date of Event
August 27, 2012
Manufacturer
ST. JUDE MEDICAL, INC. CRMD
Product Code
NVN
PMA / PMN Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIAN

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 LEAD EXHIBITED CAPTURE ANOMALY. THE LEAD WAS CAPPED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
25800 TENDRIL SDX PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, INC. CRMD 1688TC/46

Patients

Seq Age Sex Outcome Treatment
1 83 YR Required Intervention