FDA Adverse Event Injury Summary report: N

EON MINI IMPLANTABLE PULSE GENERATOR

MDR report key: 1962738 · Received January 13, 2011

Report

Report Number
1627487-2011-02048
Event Type
Injury
Date Received
January 13, 2011
Date of Event
December 15, 2010
Report Date
December 15, 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
NC, US
Reporter Occupation
NOT APPLICABLE

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

DEVICE 1 OF 3. REFERENCE MFR REPORTS: 1627487-2011-02049 AND 1627487-2011-02050. THE PT RECEIVED HER SCS SYS, INCLUDING AN IPG AND TWO PERCUTANEOUS LEADS, ON (B)(6) 2009. IT WAS REPORTED THE SCS SYS WAS EXPLANTED AND NOT REPLACED DUE TO INEFFECTIVE STIMULATION. ACCORDING TO THE PT, THE SCS THERAPIES COVERED THE DESIRED AREAS BUT WOULD "FADE" SHORTLY AFTER EACH REPROGRAMMING SESSION. THE EXPLANTED PRODUCTS WERE RETURNED TO THE MFR FOR ANALYSIS. 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 2865303

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention