FDA Adverse Event Malfunction Summary report: N

TENDRIL SDX

MDR report key: 4202275 · Received January 13, 2014

Report

Report Number
2017865-2014-04984
Event Type
Malfunction
Date Received
January 13, 2014
Date of Event
November 15, 2012
Manufacturer
ST. JUDE MEDICAL, INC., CARDIAC RHYTHM MANAGEMENT DIVISI
Product Code
NVN
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ALL INFO 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. EVAL: ANALYSIS WAS NORMAL. NO ANOMALY WAS FOUND.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE LEAD EXHIBITED NOISE IN BOTH BIPOLAR AND UNIPOLAR CONFIGURATIONS AT IMPLANT. THE LEAD ALSO EXHIBITED HIGH THRESHOLD. THE LEAD WAS NOT IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
29735 TENDRIL SDX PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, INC., CARDIAC RHYTHM MANAGEMENT DIVISI 1688TC/52

Patients

Seq Age Sex Outcome Treatment
1 85 YR