FDA Adverse Event Injury Summary report: N

EON MINI IMPLANTABLE PULSE GENERATOR

MDR report key: 1880264 · Received October 19, 2010

Report

Report Number
1627487-2010-03049
Event Type
Injury
Date Received
October 19, 2010
Date of Event
September 28, 2010
Report Date
September 28, 2010
Manufacturer
ST JUDE MEDICAL - NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P010032
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

EVAL, METHOD: THE 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. SJM 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. SJM DEFERS TO THE PT'S PHYSICIAN REGARDING MEDICAL HISTORY.

Description of Event or Problem · 1

THE PT RECEIVED HER SCS SYSTEM, INCLUDING AN IPG, ON (B)(6) 2009. IT WAS REPORTED THE IPG HAD BECOME INCREASINGLY SUPERFICIAL SINCE IMPLANT MAKING COMMUNICATION WITH THE DEVICE DIFFICULT. THE PHYSICIAN REVISED THE IPG IMPLANT POCKET, REIMPLANTING THE ORIGINAL IPG. NO PRODUCT WILL BE RETURNED. F/U ON THE PT FOUND NO FURTHER ISSUES REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EON MINI IMPLANTABLE PULSE GENERATOR TOTALLY IMPLANTABLE PULSE GENERATOR LGW ST JUDE MEDICAL - NEUROMODULATION 3788 2857934

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention