BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EON RECHARGABLE IPG

    MDR report key: 1924667 · Received December 9, 2010

    Report

    Report Number
    1627487-2010-03427
    Event Type
    Injury
    Date Received
    December 9, 2010
    Date of Event
    November 12, 2010
    Report Date
    November 12, 2010
    Manufacturer
    ST JUDE MEDICAL - NEUROMODULATION DIVISION
    Product Code
    LGW
    PMA / PMN Number
    P010032
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WV, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    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 HIS SCS SYSTEM ON (B)(6) 2005. IT WAS REPORTED THAT THE PATIENT WAS EXPERIENCING PAIN AT HIS IPG POCKET SITE. THE PHYSICIAN EXPLANTED AND REPLACED THE IPG WITH A SMALLER MODEL IPG AND MOVED THE IPG POCKET TO A DIFFERENT LOCATION. THE EXPLANTED IPG WAS RETURNED TO THE MANUFACTURER FOR EVALUATION ON (B)(6) 2010. FOLLOW UP ON THE PATIENT FOUND NO FURTHER ISSUES REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 EON RECHARGABLE IPG TOTALLY IMPLANTABLE PULSE GENERATOR LGW ST JUDE MEDICAL - NEUROMODULATION DIVISION 3716 40578A

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention