FDA Adverse Event Malfunction Summary report: N

TENDRIL ST

MDR report key: 4202176 · Received January 13, 2014

Report

Report Number
2017865-2014-04809
Event Type
Malfunction
Date Received
January 13, 2014
Date of Event
May 16, 2011
Manufacturer
ST. JUDE MEDICAL, INC. CRMD
Product Code
NVN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
NURSE

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 WAS NORMAL. NO ANOMALY WAS FOUND.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING IMPLANT THE RIGHT VENTRICULAR LEAD WOULD NOT PACE. ANOTHER LEAD WAS USED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
34671 TENDRIL ST PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, INC. CRMD 1888TC/58

Patients

Seq Age Sex Outcome Treatment
1