FDA Adverse Event Injury Summary report: N

2182207-2021-02220

MDR report key: 13061090 · Received December 22, 2021

Report

Report Number
2182207-2021-02220
Event Type
Injury
Date Received
December 22, 2021
Date of Event
December 9, 2021
Report Date
December 22, 2021
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
EZW
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 0

INFORMATION WAS RECEIVED FROM A PATIENT WHO WAS IMPLANTED WITH AN IMPLANTABLE NEUROSTIMULATOR (INS) FOR URINARY DYSFUNCTION/SACRAL NERVE STIM AND GASTROINTESTINAL/ PELVIC FLOOR. IT WAS REPORTED THAT PATIENT WAS SET TO PROGRAM 1 AT .9 OR .7V WITH THE DOCTOR. ALL OF A SUDDEN NOTHING WAS HELPING AND THEY WERE GETTING PAIN LIKE HAD A BLADDER INFECTION. THEY WOULD RUN TO BATHROOM AND NOTHING WOULD COME OUT. THE ISSUE STARTED LAST THURSDAY DECEMBER 9 AND THEY CALLED THE DOCTOR ON FRIDAY DECEMBER 10. THE DOCTOR DID A URINE TEST AND IT CAME BACK MONDAY NEGATIVE FOR UTI. IT WAS MENTIONED TO CHECK THE PROGRAMMING OF THE STIMULATOR. THE PATIENT CHECKED THEIR SETTINGS AND THE HANDSET HAD CHANGED TO A NEW SETTING, PROGRAM 4 AT 1.7V. THEY DIDN'T KNOW HOW IT CHANGED. THE PATIENT RESET IT BACK TO PROGRAM 1 AT .7V ON MONDAY MORNING. THEY WANTED TO KNOW HOW THE HANDSET CHANGED THE SETTINGS. PATIENT SERVICES EXPLAINED THAT THEY DON'T KNOW WHAT CHANGED THE SETTINGS, BUT TOLD THE PATIENT THEY DID THE RIGHT THING BY SETTING THE PROGRAMMING BACK. THE PATIENT'S PAIN STOPPED ABOUT AFTER THREE DAYS OF RESETTING THE PROGRAM AND AMPLITUDE. THEY ARE BETTER AND DON'T HAVE URGENCY PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1956785 EZW MEDTRONIC NEUROMODULATION A520

Patients

Seq Age Sex Outcome Treatment
1 81 YR Female Other