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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ST. JUDE MEDICAL, INC.(CRM-SYLMAR) TENDRIL STS; No Match

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ST. JUDE MEDICAL, INC.(CRM-SYLMAR) TENDRIL STS; No Match Back to Search Results
Model Number 2088TC/52
Device Problems Device Dislodged or Dislocated (2923); Insufficient Information (3190)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Type  Injury  
Event Description
It was reported that the patient presented with a dislodged right atrial lead associated with an unknown electrical anomaly.The dislodgement was confirmed via fluoroscopy.The lead was explanted and replaced.The patient was stable.
 
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Brand Name
TENDRIL STS
Type of Device
No Match
Manufacturer (Section D)
ST. JUDE MEDICAL, INC.(CRM-SYLMAR)
15900 valley view court
sylmar CA 91342
Manufacturer (Section G)
ST. JUDE MEDICAL, INC.(CRM-SYLMAR)
15900 valley view court
sylmar CA 91342
Manufacturer Contact
richard williamson
15900 valley view court
sylmar, CA 91342
MDR Report Key18966710
MDR Text Key338429083
Report Number2017865-2024-35759
Device Sequence Number1
Product Code NVN
UDI-Device Identifier05414734502887
UDI-Public05414734502887
Combination Product (y/n)Y
Reporter Country CodeUS
PMA/PMN Number
P960013
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,User Facility,Company Representative
Reporter Occupation Physician
Type of Report Initial
Report Date 03/25/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number2088TC/52
Device Lot NumberP000183273
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 03/14/2024
Initial Date FDA Received03/25/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured10/12/2023
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Treatment
ASSURITY MRI; TENDRIL
Patient Outcome(s) Required Intervention;
Patient Age85 YR
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