FDA Adverse Event Injury Summary report: N

EON MINI IMPLANTABLE PULSE GENERATOR

MDR report key: 1884101 · Received October 21, 2010

Report

Report Number
1627487-2010-03013
Event Type
Injury
Date Received
October 21, 2010
Date of Event
September 27, 2010
Report Date
July 7, 2017
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P010032
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

EVALUATION 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 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. SJM DEFERS TO THE PATIENT'S PHYSICIAN REGARDING MEDICAL HISTORY.

Description of Event or Problem · 1

THE PATIENT RECEIVED HER SCS SYSTEM, INCLUDING AN IPG, ON (B)(6)2010. IT WAS REPORTED THE PATIENT LOST STIMULATION AND THE DEVICE HAD STOPPED COMMUNICATING WITH THE DEVICE CHARGER. AN EXAMINATION OF THE PATIENT'S SCS SYSTEM FOUND THE IPG HAD FLIPPED WITHIN THE IPG IMPLANT POCKET. THE PHYSICIAN PLANS TO SURGICALLY REPOSITION THE DEVICE; THEREFORE, NO PRODUCTS WILL BE RETURNED. FOLLOW UP ON THE PATIENT FOUND NO FURTHER ISSUES REPORTED.

Description of Event or Problem · 1

FOLLOW-UP IDENTIFIED THE PATIENT UNDERWENT SURGICAL INTERVENTION ON (B)(6) 2017 DURING WHICH THE IPG WAS EXPLANTED AND REPLACED. STIMULATION WAS RESTORED FOLLOWING THE PROCEDURE.

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 3131341

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention