BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    TENDRIL DX

    MDR report key: 4190201 · Received January 11, 2014

    Report

    Report Number
    2017865-2014-02215
    Event Type
    Malfunction
    Date Received
    January 11, 2014
    Date of Event
    May 21, 2012
    Manufacturer
    ST. JUDE MEDICAL, CRMD
    Product Code
    DTB
    PMA / PMN Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    NURSE

    Narratives

    Additional Manufacturer Narrative · 1

    ALL INFO WAS PROVIDED BY MFR, NO MEDWATCH FORM WAS RECEIVED. 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 PT PRESENTED IN CLINIC FOR A ROUTINE FOLLOW UP. THE RIGHT VENTRICULAR LEAD EXHIBITED HIGH AND OUT OF RANGE IMPEDANCE. THE PT WILL CONTINUE TO BE MONITORED. THE LEAD REMAINED IMPLANTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    21586 TENDRIL DX PERMANENT PACEMAKER ELECTRODE DTB ST. JUDE MEDICAL, CRMD 1388TC/52

    Patients

    Seq Age Sex Outcome Treatment
    1 79 YR