MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2020-03-31 for TENDRIL STS 2088TC/52 2088TC-52 manufactured by St. Jude Medical, Inc.(crm-sylmar).
[185940463]
This product is registered as a combination product. The results of the investigation are inconclusive since the device was not returned for analysis. Based on the information received, the cause of the reported incident could not be conclusively determined.
Patient Sequence No: 1, Text Type: N, H10
[185940464]
It was reported that the patient reported fatigue and left pectoral stimulation and presented remotely via merlin. Net. Upon investigation, the right ventricular lead was noted with increased thresholds. The patient presented in clinic for a device check. Upon investigation, the patient was in high output mode with intermittent loss of capture. The patient was admitted and taken to the cath lab for lead repositioning. During procedure, the lead was found a little losse but still connected. Microdislodgement was suspected. No other product malfunction was noted on the lead. The lead was repositioned. The patient stayed overnight and discharged the following day after normal device check.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2017865-2020-04486 |
| MDR Report Key | 9908070 |
| Report Source | COMPANY REPRESENTATIVE,HEALTH |
| Date Received | 2020-03-31 |
| Date of Report | 2020-03-31 |
| Date of Event | 2020-03-27 |
| Date Mfgr Received | 2020-03-28 |
| Device Manufacturer Date | 2020-02-28 |
| Date Added to Maude | 2020-03-31 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | ELIZABETH BOLTZ |
| Manufacturer Street | 15900 VALLEY VIEW COURT |
| Manufacturer City | SYLMAR CA 91342 |
| Manufacturer Country | US |
| Manufacturer Postal | 91342 |
| Manufacturer G1 | ST. JUDE MEDICAL, INC.(CRM-SYLMAR) |
| Manufacturer Street | 15900 VALLEY VIEW COURT |
| Manufacturer City | SYLMAR CA 91342 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 91342 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | TENDRIL STS |
| Generic Name | PERMANENT PACEMAKER ELECTRODE |
| Product Code | NVN |
| Date Received | 2020-03-31 |
| Model Number | 2088TC/52 |
| Catalog Number | 2088TC-52 |
| Lot Number | A000094105 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ST. JUDE MEDICAL, INC.(CRM-SYLMAR) |
| Manufacturer Address | 15900 VALLEY VIEW COURT SYLMAR CA 91342 US 91342 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2020-03-31 |