FDA Adverse Event Injury Summary report: N

EON MINI IPG

MDR report key: 1924715 · Received December 9, 2010

Report

Report Number
1627487-2010-03472
Event Type
Injury
Date Received
December 9, 2010
Date of Event
November 10, 2010
Report Date
November 10, 2010
Manufacturer
ST JUDE MEDICAL - NEUROMODULATION DIVISION
Product Code
LGW
PMA / PMN Number
P010032
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

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 WAS IMPLANTED WITH AN IPG ON (B)(6) 2010. IT WAS REPORTED THAT SHE WAS UNABLE TO COMMUNICATE WITH THE DEVICE USING MULTIPLE PROGRAMMERS AND CHARGING SYSTEMS. THE IPG WAS REPLACED ON (B)(6) 2010 AND HAS BEEN RETURNED TO THE MANUFACTURER FOR ANALYSIS. FOLLOW-UP ON THE PT FOUND NO OTHER ISSUES REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EON MINI IPG TOTALLY IMPLANTABLE PULSE GENERATOR LGW ST JUDE MEDICAL - NEUROMODULATION DIVISION 3788 2881387

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention