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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Abbott Medical (CRM-Sylmar) TENDRIL STS; Drug Eluting Permanent Right Ventricular (Rv) Or Right Atrial (Ra) Pacemaker Electrodes

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Abbott Medical (CRM-Sylmar) TENDRIL STS; Drug Eluting Permanent Right Ventricular (Rv) Or Right Atrial (Ra) Pacemaker Electrodes Back to Search Results
Model Number 2088TC/52
Medical Device Problem Code Insufficient Device Problem Information (3190)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 09/09/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the patient¿s right atrial lead was capped and replaced on (b)(6) 2026 due to an unspecified issue.The patient's condition was not known.
 
Additional Manufacturer Narrative
Further information was requested but not received.
 
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Brand Name
TENDRIL STS
Common Device Name
Drug Eluting Permanent Right Ventricular (Rv) Or Right Atrial (Ra) Pacemaker Electrodes
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 Key50927443
Report Number2017865-2026-20491
Device Sequence Number9525720
Product Code NVN
UDI-Device Identifier05414734502887
UDI-Public(01)05414734502887(10)P000010090(17)180531
Combination Product (Y/N)Y
Initial Reporter StateNJ
Initial Reporter CountryUS
PMA/510(K) Number
P960013
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2015
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) 09/29/2026
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 Date05/31/2018
Device Model Number2088TC/52
Device Lot NumberP000010090
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 09/11/2026
Initial Report FDA Received Date09/29/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured06/08/2015
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 Active Lead.; Fortify Assura DR ICD.
Outcome Attributed to Adverse Event Required Intervention;
Patient Age62 YR
Patient SexMale
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