BEUDAMED
    FDA Adverse Event Death Summary report: N

    EON IMPLANTABLE PULSE GENERATOR

    MDR report key: 1674010 · Received April 30, 2010

    Report

    Report Number
    1627487-2010-00400
    Event Type
    Death
    Date Received
    April 30, 2010
    Date of Event
    September 3, 2009
    Report Date
    March 3, 2010
    Manufacturer
    ADVANCED NEUROMODULATION SYSTEMS
    Product Code
    LGW
    PMA / PMN Number
    P010032
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    EVALUATION, DEVICE HISTORY AND STERILIZATION RECORDS WERE REVIEWED. RESULTS: THE DEVICE HISTORY AND STERILIZATION RECORDS REVIEWED WERE FOUND TO MEET SPECIFICATIONS AND NO ANOMALIES WERE FOUND. CONCLUSION: THE CAUSE OF THE REPORTED COMPLAINT COULD NOT BE DETERMINED FROM THE REVIEW OF THE DHR AND STERILIZATION RECORDS. THIS MDR IS BEING SUBMITTED PAST THE 30 DAY REPORTING REQUIREMENT AS PART OF A RETROSPECTIVE REVIEW INITIATED IN A RESPONSE TO AN FDA INSPECTION. A RETROSPECTIVE REVIEW OF THE COMPLAINT RECORD DETERMINED THAT ANS MISINTERPRETED THE MDR REGULATIONS IN THIS INSTANCE. ANS HAS LIMITED INFORMATION RELATED TO THE PATIENT'S MEDICAL HISTORY AND IS UNABLE TO FORM AN OPINION AS TO THE RELEVANCY OF THE PATIENT'S HISTORY TO THE EVENT REPORTED. ANS DEFERS TO THE PATIENT'S PHYSICIAN REGARDING MEDICAL HISTORY.

    Description of Event or Problem · 1

    THE PATIENT RECEIVED HIS ANS SCS SYSTEM ON (B) (6) 2006. IT WAS REPORTED THAT A SALES REPRESENTATIVE FROM A COMPETITOR COMPANY RECEIVED THIS PATIENT'S IPG FROM A MORTUARY AND SHE SHIPPED IT BACK TO ANS. THAT SALES REPRESENTATIVE HAD THE PATIENT'S NAME AND DEVICE SERIAL NUMBER, BUT NO FURTHER INFORMATION WAS PROVIDED. ANS HAS NO INFORMATION ON WHO THE PATIENT'S CURRENT PHYSICIAN WAS OR THE REPORTED CAUSE OF DEATH. THE ANS SALES REPRESENTATIVE HAD NOT SPOKEN TO NOR SEEN THE PATIENT IN SEVERAL YEARS. NO FURTHER INFORMATION IS AVAILABLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 EON IMPLANTABLE PULSE GENERATOR TOTALLY IMPLANTABLE PULSE GENERATOR LGW ADVANCED NEUROMODULATION SYSTEMS 3716 63497

    Patients

    Seq Age Sex Outcome Treatment
    1 Death