BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MEDTRONIC

    MDR report key: 1588691 · Received January 24, 2010

    Report

    Report Number
    MW5014489
    Event Type
    Injury
    Date Received
    January 24, 2010
    Date of Event
    January 21, 2010
    Report Date
    January 23, 2010
    Manufacturer
    MEDTRONIC
    Product Code
    EZW
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    HAD INTERSTIM REMOVED 2 DAYS AGO DUE TO SEVERE BACK AND LEFT LEG PAIN. IT IS BELIEVED TO HAVE PUT PRESSURE ON MY SIATICA NERVE. SINCE IT HAS BEEN REMOVED, THERE IS NO MORE PAIN IN MY BACK OR MY LEFT LEG. PEOPLE SHOULD BE MADE AWARE OF THIS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDTRONIC INTERSTIM EZW MEDTRONIC 3023 STIMULATOR

    Patients

    Seq Age Sex Outcome Treatment
    1 69 YR Required Intervention