FDA Adverse Event Malfunction Summary report: N

TENDRIL SDX

MDR report key: 4193536 · Received January 13, 2014

Report

Report Number
2017865-2014-05529
Event Type
Malfunction
Date Received
January 13, 2014
Date of Event
June 6, 2011
Manufacturer
ST. JUDE MEDICAL, INC CRMD
Product Code
DTB
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
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. THE REPORTED FIELD EVENT OF UNACCEPTABLE THRESHOLD WAS NOT CONFIRMED. ANALYSIS WAS NORMAL. NO ANOMALY WAS FOUND.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING IMPLANT THE LEAD EXHIBITED UNACCEPTABLE THRESHOLDS AND SENSING ANOMALY. THE LEAD WAS REMOVED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
34689 TENDRIL SDX PERMANENT PACEMAKER ELECTRODE, DTB DTB ST. JUDE MEDICAL, INC CRMD 1688TC/52

Patients

Seq Age Sex Outcome Treatment
1 85 YR