| 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 Key | 50947200 |
| Report Number | 2017865-2026-20519 |
| Device Sequence Number | 15859055 |
| Product Code |
NVN
|
| UDI-Device Identifier | 05414734502894 |
| UDI-Public | (01)05414734502894(10)A000175432(17)280531 |
| Combination Product (Y/N) | Y |
| Initial Reporter Country | GM |
| PMA/510(K) Number | P960013 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2025 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Health Professional,Company Representative |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
09/30/2026 |
| 1 Device was Involved in the Event |
|
| 1 Patient was Involved in the Event |
|
| Is this an Adverse Event Report? |
No
|
| Is this a Product Problem Report? |
Yes
|
| Operator of Device |
Health Professional
|
| Device Model Number | 2088TC/58 |
| Device Lot Number | A000175432 |
| 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 | 09/12/2026 |
| Initial Report FDA Received Date | 09/30/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 06/20/2025 |
| 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 Number | 1 |
Concomitant Medical Products and Therapy/Usage Dates | Model #2088TC/52 TENDRIL STS; Model #PM2162 Endurity Pacemaker |
| Patient Sex | Unknown |