FDA Adverse Event Malfunction Summary report: N

EON RECHARGEABLE IPG

MDR report key: 2080252 · Received April 7, 2011

Report

Report Number
1627487-2011-01352
Event Type
Malfunction
Date Received
April 7, 2011
Date of Event
March 9, 2011
Report Date
March 10, 2011
Manufacturer
ST JUDE MEDICAL - NEUROMODULATION DIVISION
Product Code
LGW
PMA / PMN Number
P010032
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, 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 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 RECEIVED HIS SCS SYSTEM, INCLUDING AN IPG ON (B)(6) 2007. IT WAS REPORTED THAT THE PATIENT LOST STIMULATION AND THE PT LOST STIMULATION AND LAST USED HIS CHARGER APPROXIMATELY ONE MONTH AGO. THE PATIENT'S CHARGER AND PROGRAMMER ALLEGEDLY WOULD NOT COMMUNICATE WITH THE IPG. A NEW CHARGING SYSTEM WAS SENT TO THE PATIENT. ATTEMPTS TO OBTAIN ADDITIONAL INFORMATION REGARDING THE PATIENT'S CONDITION AND/OR DEVICE STATUS WERE UNSUCCESSFUL. ACCORDING TO THE MANUFACTURER'S DEVICE REGISTRATION SYSTEM, THE IPG REMAINS IMPLANTED. NO FURTHER PATIENT COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EON RECHARGEABLE IPG TOTALLY IMPLANTABLE PULSE GENERATOR LGW ST JUDE MEDICAL - NEUROMODULATION DIVISION 3716 96907

Patients

Seq Age Sex Outcome Treatment
1 39 YR Required Intervention