FDA Adverse Event Malfunction Summary report: N

TENDRIL SDX

MDR report key: 4202286 · Received January 13, 2014

Report

Report Number
2017865-2014-04961
Event Type
Malfunction
Date Received
January 13, 2014
Date of Event
July 18, 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
JA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). 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. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING THE PROCEDURE, THE LEAD EXHIBITED A THRESHOLD ANOMALY. THE LEAD WAS REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
29073 TENDRIL SDX PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, INC., CARDIAC RHYTHM MANAGEMENT DIVISI 1688TC/46

Patients

Seq Age Sex Outcome Treatment
1