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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ST. JUDE MEDICAL, INC.(CRM-SYLMAR) QUADRA ASSURA CRT-D QUAD RF HV; NO MATCH

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ST. JUDE MEDICAL, INC.(CRM-SYLMAR) QUADRA ASSURA CRT-D QUAD RF HV; NO MATCH Back to Search Results
Model Number CD3365-40Q
Medical Device Problem Code Over-Sensing (1438)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/07/2025
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that patient presented remotely via merlin.Net.Review of transmission revealed that non-sustained right ventricular oversensing (nsrvo) due to far p wave over-sensing.Programming changes were suggested but no intervention was performed.Patient condition was stable.
 
Additional Manufacturer Narrative
The reported events of far p oversensing was not confirmed.The device voltage was at elective replacement indicator (eri) upon receipt.Analysis of device image was performed, and no anomalies were noted.A longevity calculation was performed and found the battery depletion was normal based on the device usage.Electrical testing was performed, and no anomalies were noted.
 
Event or Problem Description
New information noted that an icd was explanted and replaced with new icd.
 
Additional Manufacturer Narrative
Correction: "device evaluation" box should also be selected for h2.
 
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Brand Name
QUADRA ASSURA CRT-D QUAD RF HV
Common Device Name
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
navpreet singh
15900 valley view court
sylmar, CA 91342
MDR Report Key23379125
Report Number2017865-2025-1003335
Device Sequence Number8824510
Product Code NIK
UDI-Device Identifier05414734508292
UDI-Public(01)05414734508292(10)A000019874(17)180331
Combination Product (Y/N)N
Initial Reporter StateOR
Initial Reporter CountryUS
PMA/510(K) Number
P030054
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2016
Device Explanted Year2026
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,User Facility,Company Representative
Initial Reporter Occupation Nurse
Type of Report Initial,Followup,Followup
Report Date (Section B) 02/25/2026
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
Operator of Device Health Professional
Device Expiration Date03/31/2018
Device Model NumberCD3365-40Q
Device Catalogue NumberCD3365-40Q
Device Lot NumberA000019874
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 10/07/2025
Supplement Date Received by Manufacturer01/28/2026
02/23/2026
Initial Report FDA Received Date10/24/2025
Supplement Report FDA Received Date02/18/2026
02/25/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/19/2016
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
OPTISURE.; QUARTET.; TENDRIL.
Outcome Attributed to Adverse Event Required Intervention;
Patient Age77 YR
Patient SexMale
Patient Weight73 KG
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