FDA Adverse Event Injury Summary report: N

PULSE GEN MODEL 102

MDR report key: 2052577 · Received April 8, 2011

Report

Report Number
1644487-2011-00754
Event Type
Injury
Date Received
April 8, 2011
Date of Event
March 27, 2007
Report Date
March 10, 2011
Manufacturer
CYBERONICS, INC.
Product Code
LYJ
PMA / PMN Number
P970003
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

REPORTER INDICATED THAT A VNS PATIENT HAD A HISTORY OF MODERATE OBSTRUCTIVE SLEEP APNEA SINCE AT LEAST (B)(6) 2007. THE PATIENT USES A C-PAP MACHINE FOR THE SLEEP APNEA. THE PATIENT RECENTLY HAD VNS GENERATOR REPLACEMENT SURGERY DUE TO END OF SERVICE. ATTEMPTS FOR FURTHER INFORMATION AND RETURN OF THE EXPLANTED GENERATOR ARE IN PROGRESS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PULSE GEN MODEL 102 LYJ CYBERONICS, INC. 102 011406

Patients

Seq Age Sex Outcome Treatment
1 14 YR Required Intervention