FDA Adverse Event Injury Summary report: N

EON MINI IMPLANTABLE PULSE GENERATOR

MDR report key: 1990687 · Received February 8, 2011

Report

Report Number
1627487-2011-02158
Event Type
Injury
Date Received
February 8, 2011
Date of Event
January 17, 2011
Report Date
January 17, 2011
Manufacturer
ST JUDE MEDICAL - NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P010032
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IS
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

THE PT ((B)(6)) RECEIVED AN SCS SYSTEM, INCLUDING AN IPG, ON (B)(6) 2009. IT WAS REPORTED THE IPG WAS EXPLANTED AND REPLACED DUE TO INTERMITTENT STIMULATION. THE EXPLANTED IPG WAS RETURNED TO THE MFR FOR ANALYSIS, HOWEVER, ANALYSIS IS IN PROCESS AT THIS TIME. NO ADDITIONAL INFO IS AVAILABLE.

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 2796639

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention