FDA Adverse Event Malfunction Summary report: N

TENDRIL ST

MDR report key: 4201662 · Received January 13, 2014

Report

Report Number
2017865-2014-04714
Event Type
Malfunction
Date Received
January 13, 2014
Date of Event
October 31, 2012
Manufacturer
ST. JUDE MEDICAL, INC., CRMD
Product Code
NVN
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, 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. EVAL DESCRIPTION: ANALYSIS IS NORMAL. THERE WERE NO ANOMALIES DETECTED WITH THIS DEVICE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE ATRIAL LEAD EXHIBITED LOW IMPEDANCE HIGH PACING THRESHOLD AND UNDER SENSING. THE LEAD WAS NOT IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
28918 TENDRIL ST PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, INC., CRMD 1888TC/46

Patients

Seq Age Sex Outcome Treatment
1 70 YR