BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    EON IMPLANTABLE PULSE GENERATOR

    MDR report key: 1790917 · Received August 6, 2010

    Report

    Report Number
    1627487-2010-01521
    Event Type
    Malfunction
    Date Received
    August 6, 2010
    Date of Event
    November 4, 2009
    Report Date
    November 5, 2009
    Manufacturer
    ADVANCED NEUROMODULATION SYSTEMS
    Product Code
    LGW
    PMA / PMN Number
    P010032
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    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. ANS HAS LIMITED INFO RELATED TO THE PT¿S MEDICAL HISTORY AND IS UNABLE TO FORM AN OPINION AS TO THE RELEVANCY OF THE PT¿S HISTORY TO THE EVENT REPORTED. ANS DEFERS TO THE PT¿S PHYSICIAN REGARDING MEDICAL HISTORY.

    Description of Event or Problem · 1

    DEVICE 1 OF 2. SEE MFR REPORT 1627487-2010-01525. THE PT RECEIVED HER SCS SYSTEM ON (B)(6) 2007. IT WAS REPORTED THAT THE PT SUFFERED A FALL ON (B)(6) 2009 AND SUBSEQUENTLY LOST STIMULATION. REPROGRAMMING WAS ATTEMPTED WITHOUT SUCCESS. THE PT¿S IPG AND LEADS WERE EXPLANTED ON (B)(6) 2009 AND RETURNED TO THE MFR FOR EVAL. NO FURTHER INFO 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 64271

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention