FDA Adverse Event Malfunction Summary report: N

TENDRILL STS

MDR report key: 4202302 · Received January 13, 2014

Report

Report Number
2017865-2014-04951
Event Type
Malfunction
Date Received
January 13, 2014
Date of Event
May 16, 2011
Manufacturer
ST. JUDE MEDICAL, CARDIAC RHYTHM MANAGEMENT DIVISI
Product Code
NVN
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, 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. 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 PATIENTS CHRONIC LEAD HAD HIGH THRESHOLD. THE PHYSICIAN ATTEMPTED TO REPLACE THE LEAD BUT COULD NOT OBTAIN BETTER THRESHOLDS. THE NEW WAS NOT IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
29739 TENDRILL STS PERMANENT PACEMAKER ELECTRODE NVN ST. JUDE MEDICAL, CARDIAC RHYTHM MANAGEMENT DIVISI 1688TC/46

Patients

Seq Age Sex Outcome Treatment
1 67 YR