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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL (CRM-SYLMAR) TENDRIL MRI; No Match

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ABBOTT MEDICAL (CRM-SYLMAR) TENDRIL MRI; No Match Back to Search Results
Model Number LPA1200M/46
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Unspecified Infection (1930)
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the patient's implantable cardioverter defibrillator (icd), right atrial (ra) lead, and left ventricular (lv) lead were explanted due to an infection.The patient's condition was not known.
 
Additional Manufacturer Narrative
A device history record (dhr) review was performed and review of the sterilization records confirmed normal sterilization cycles for the products.The device met specifications prior to leaving abbott manufacturing facilities.
 
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Brand Name
TENDRIL MRI
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 Key25521719
Report Number2017865-2026-12483
Device Sequence Number10553302
Product Code NVN
UDI-Device Identifier05414734504683
UDI-Public(01)05414734504683(10)P000165414(17)260228
Combination Product (Y/N)Y
Initial Reporter StateGA
Initial Reporter CountryUS
PMA/510(K) Number
P140033
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2026
Device Explanted Year2026
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,User Facility,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 06/16/2026
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 Date02/28/2026
Device Model NumberLPA1200M/46
Device Lot NumberP000165414
Was Device Available for Evaluation? No
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 05/26/2026
Initial Report FDA Received Date06/16/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured03/17/2023
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 Required Intervention;
Patient Age73 YR
Patient SexFemale
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