FDA Adverse Event Injury Summary report: N

EON IMPLANTABLE PULSE GENERATOR

MDR report key: 1944757 · Received December 15, 2010

Report

Report Number
1627487-2010-02690
Event Type
Injury
Date Received
December 15, 2010
Date of Event
February 11, 2010
Report Date
February 22, 2010
Manufacturer
ST. JUDE MEDICAL -NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P010032
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

EVAL METHOD: DEVICE HISTORY AND STERILIZATION RECORDS WERE REVIEWED. RESULTS: THE DEVICE HISTORY AND STERILIZATION RECORDS WERE REVIEWED AND WERE FOUND TO MEET SPECS 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. THIS MDR IS BEING SUBMITTED PAST THE 30 DAY REPORTING REQUIREMENT AS PART OF A RETROSPECTIVE REVIEW INITIATED IN RESPONSE TO AN FDA INSPECTION. WE ARE SUBMITTING THIS MDR AS THE RESULT OF A RE-EVALUATION OF OUR MDR REVIEW PROCESS. 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) 2010, FOR THE TREATMENT OF MIGRAINES (OFF-LABEL USE). THE PT REPORTED A POPPING SENSATION IN HER CHEST AT THE IPG POCKET SITE, FOLLOWED BY A SURGE OF OVERSTIMULATION. AS TIME PROGRESSED, THE PT ADVISED, SHE EXPERIENCED WORSENING HEATING SENSATIONS AT THE IPG SITE AND INTERMITTENT STIMULATION. AN X-RAY WAS TAKEN BUT NO ANOMALIES WERE FOUND. DIAGNOSTIC TESTING OF THE LEAD SHOWED NORMAL IMPEDANCE ON ALL CONTACTS. THE IPG WAS EXPLANTED AND REPLACED. THE EXPLANTED IPG WAS RETAINED BY THE FACILITY. F/U ON THE PT FOUND NO FURTHER ISSUES REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EON IMPLANTABLE PULSE GENERATOR SPINAL CORD STIMULATION LEAD LGW ST. JUDE MEDICAL -NEUROMODULATION 3716 2757141

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention