BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TENDRIL ST

    MDR report key: 4191780 · Received January 13, 2014

    Report

    Report Number
    2017865-2014-04598
    Event Type
    Injury
    Date Received
    January 13, 2014
    Date of Event
    July 9, 2012
    Manufacturer
    ST. JUDE MEDICAL, CRMD
    Product Code
    NVN
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FR
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    ALL INFORMATION PROVIDED BY MANUFACTURER, 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. EVALUATION DESCRIPTION: FINAL ANALYSIS FOUND AN ELECTRICAL SHORT CAUSED BY DAMAGED INSULATION. VISUAL INSPECTION REVEALED OUTER COIL SQUEEZED AT 21.8 CM FROM END OF CONNECTOR PIN AND INNER INSULATION WAS DAMAGED AT THE SAME LOCATION.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT DURING IMPLANT THE LEAD EXHIBITED NO DETECTION AND LOW LEAD IMPEDANCE. THE LEAD WAS REMOVED AND REPLACED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    29565 TENDRIL ST PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, CRMD 1888TC/52

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention