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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 1888TC/52
Medical Device Problem Codes Fracture (1260); Over-Sensing (1438)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that reproducible noise leading to pacing inhibition was noted on the right atrial (ra) lead.A lead fracture was suspected.The patient is completely pacer dependent.The ra lead was capped and replaced on (b)(6) 2026.There were no adverse events for the patient.
 
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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 Key25700724
Report Number2017865-2026-14075
Device Sequence Number9670343
Product Code NVN
UDI-Device Identifier05414734501750
UDI-Public(01)05414734501750(10)3120096(17)130430
Combination Product (Y/N)Y
Initial Reporter StateWV
Initial Reporter CountryUS
PMA/510(K) Number
P960013
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2010
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) 07/02/2026
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 Date04/30/2013
Device Model Number1888TC/52
Device Lot Number3120096
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 06/16/2026
Initial Report FDA Received Date07/03/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured04/28/2010
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
DURATA.; ELLIPSE.
Outcome Attributed to Adverse Event Required Intervention;
Patient SexFemale
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