FDA Adverse Event Malfunction Summary report: N

RESTORE

MDR report key: 1062281 · Received June 18, 2008

Report

Report Number
2182207-2008-03348
Event Type
Malfunction
Date Received
June 18, 2008
Date of Event
May 1, 2008
Report Date
May 22, 2008
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P840001
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THE PATIENT WAS INJURED ON THE SAME SIDE AS THE NEUROSTIMULATOR DURING A CAR ACCIDENT. THE DEVICE DISCHARGED; THE PATIENT RECEIVED NO STIMULATION. A PHYSICIAN MODE RECHARGE (PMR) WAS PERFORMED BY THE PATIENT. TWO DAYS LATER THE BATTERY WAS DEPLETED AGAIN. A POWER ON RESET (POR) CONDITION OCCURRED. THE PATIENT WAS INSTRUCTED TO RECHARGE THE DEVICE UNTIL THE DEVICE WAS AT LEAST 25% CHARGED BEFORE INTERROGATING THE DEVICE. THE PATIENT CONTINUES TO HAVE DIFFICULTY RECHARGING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 RESTORE LGW MEDTRONIC NEUROMODULATION UNK NA

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention