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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL (CRM-SYLMAR) TENDRIL ST; NO MATCH

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ABBOTT MEDICAL (CRM-SYLMAR) TENDRIL ST; NO MATCH Back to Search Results
Model Number 1882TC/46
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/19/2026
Type of Reportable Event Death
Additional Manufacturer Narrative
Further information was requested but not received.
 
Event or Problem Description
It was reported that the patient died on (b)(6) 2026 due to an unknown cause.No further information was provided.
 
Additional Manufacturer Narrative
The reported event was patient deceased.As received, only a connector portion of the lead was returned in one piece for analysis.Visual inspection and x-ray examination of the lead found no anomalies with the exception of damage consistent with procedural damage.Electrical testing did not find any indication of conductor fractures or internal shorts.
 
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Brand Name
TENDRIL ST
Common Device Name
NO MATCH
Manufacturer (Section D)
ABBOTT MEDICAL (CRM-SYLMAR)
15900 valley view court
sylmar CA 91342
Manufacturer (Section G)
ABBOTT MEDICAL (CRM-SYLMAR)
15900 valley view court
sylmar CA 91342
Manufacturer Contact
navpreet singh
15900 valley view court
sylmar, CA 91342
MDR Report Key24848379
Report Number2017865-2026-07515
Device Sequence Number8935930
Product Code NVN
UDI-Device Identifier05414734501774
UDI-Public(01)05414734501774(10)A000019771(17)190228
Combination Product (Y/N)Y
Initial Reporter StatePA
Initial Reporter CountryUS
PMA/510(K) Number
P960013
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2017
Device Explanted Year2026
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,User Facility
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 05/08/2026
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? No
Operator of Device Health Professional
Device Expiration Date02/28/2019
Device Model Number1882TC/46
Device Lot NumberA000019771
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/23/2026
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 03/23/2026
Supplement Date Received by Manufacturer04/20/2026
Initial Report FDA Received Date04/11/2026
Supplement Report FDA Received Date05/08/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/17/2016
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
Outcome Attributed to Adverse Event Death;
Patient SexFemale
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