FDA Adverse Event Malfunction Summary report: N

EON MINI IPG, 16-CHANNEL RECHARGEABLE

MDR report key: 2062209 · Received March 17, 2011

Report

Report Number
1627487-2011-00372
Event Type
Malfunction
Date Received
March 17, 2011
Date of Event
February 1, 2011
Report Date
February 17, 2011
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION DIVISION
Product Code
LGW
PMA / PMN Number
P010032
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT IS BEING SUBMITTED AS A PRECAUTIONARY MEASURE AS SIMILARLY REPORTED EVENTS HAVE LED TO THE EXPLANT OF THE IPG. SJM HAS LIMITED INFORMATION RELATED TO THE PATIENT'S MEDICAL HISTORY AND IS UNABLE TO FORM AN OPINION AS TO THE RELEVANCY OF THE PATIENT'S HISTORY TO THE EVENT REPORTED. SJM DEFERS TO THE PATIENT'S PHYSICIAN REGARDING MEDICAL HISTORY.

Description of Event or Problem · 1

THE PATIENT WAS IMPLANTED WITH AN IPG ON (B)(6) 2009. IT WAS REPORTED THAT THE PATIENT IS WITHOUT STIMULATION AND UNABLE TO POWER ON HIS CHARGING SYSTEM. IN AN EFFORT TO RESOLVE THIS MATTER, A REPLACEMENT CHARGING SYSTEM WAS SHIPPED TO THE PATIENT. NO FURTHER INFORMATION IS AVAILABLE AT THIS TIME AS ALL ATTEMPTS TO CONFIRM RESOLUTION HAVE BEEN UNSUCCESSFUL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EON MINI IPG, 16-CHANNEL RECHARGEABLE TOTALLY IMPLANTABLE PULSE GENERATOR LGW ST. JUDE MEDICAL - NEUROMODULATION DIVISION 3788 2784597

Patients

Seq Age Sex Outcome Treatment
1 35 YR Required Intervention