FDA Adverse Event
Malfunction
Summary report: N
EON MINI RECHARGEABLE IPG
MDR report key: 2062510
·
Received March 22, 2011
Report
- Report Number
- 1627487-2011-01277
- Event Type
- Malfunction
- Date Received
- March 22, 2011
- Date of Event
- February 19, 2011
- Report Date
- February 21, 2011
- Manufacturer
- ST JUDE MEDICAL - NEUROMODULATION DIVISION
- Product Code
- LGW
- PMA / PMN Number
- P010032
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IL, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
THIS REPORT IS BEING SUBMITTED AS A PRECAUTIONARY MEASURE AS SIMILAR ALLEGED EVENTS HAVE OCCASIONALLY RESULTED IN THE EXPLANT OF THE IPG. SJM HAS LIMITED INFORMATION 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 REC'D HIS SCS SYSTEM, INCLUDING AN IPG, ON (B)(6) 2009. IT WAS REPORTED THAT THE PT'S IPG WAS UNABLE TO COMMUNICATE WITH THE CHARGER. A REPLACEMENT CHARGING SYSTEM WAS SENT TO THE PT; HOWEVER, IT IS CURRENTLY UNDETERMINED WHETHER THE REPLACEMENT EXTERNAL DEVICE RESOLVED THE ISSUE. NO FURTHER INFORMATION IS AVAILABLE AT THIS TIME.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | EON MINI RECHARGEABLE IPG | TOTALLY IMPLANTABLE PULSE GENERATOR | LGW | ST JUDE MEDICAL - NEUROMODULATION DIVISION | 3788 | 2791009 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 53 YR | Required Intervention |