FDA Adverse Event Malfunction Summary report: N

SPINAL CORD STIMULATOR

MDR report key: 1232532 · Received November 13, 2008

Report

Report Number
2182207-2008-07455
Event Type
Malfunction
Date Received
November 13, 2008
Date of Event
October 12, 2008
Report Date
November 12, 2008
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P840001
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT WHEN THE PATIENT INCREASED STIMULATION SHE HAD INCREASED HEADACHES. IT FELT LIKE THE 'LEADS WERE SWOLLEN' TO THE PATIENT. THERE WAS NO KNOWN INCIDENT OR ACCIDENT RELATED TO THE COMPLAINT. THE SYMPTOMS BEGAN 4 DAYS PRIOR TO THE REPORT DATE. THE DEVICE SYSTEM WAS EXPLANTED (DATE UNK). ADDITIONAL INFORMATION HAS BEEN REQUESTED. A FOLLOW-UP REPORT WILL BE SUBMITTED IF ADDITIONAL INFORMATION BECOMES AVAILABLE.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention IMPLANTED:| EXPLANTED:| LEAD: MODEL UNK