FDA Adverse Event Injury Summary report: N

EON IMPLANTABLE PULSE GENERATOR

MDR report key: 2113687 · Received June 2, 2011

Report

Report Number
1627487-2011-02709
Event Type
Injury
Date Received
June 2, 2011
Date of Event
May 6, 2011
Report Date
May 6, 2011
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P010032
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

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 AN SCS SYSTEM, INCLUDING AN IPG, ON (B)(6) 2007. IT WAS REPORTED THE IPG WAS EXPLANTED AND REPLACED DUE TO DISCOMFORT AT THE IPG POCKET. NO PATIENT COMPLICATIONS WERE REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EON IMPLANTABLE PULSE GENERATOR TOTALLY IMPLANTABLE PULSE GENERATOR LGW ST. JUDE MEDICAL - NEUROMODULATION 3716 85046

Patients

Seq Age Sex Outcome Treatment
1 47 YR Required Intervention SCS LEAD: MODEL 3181 (3)| SCS EXTENSION: MODEL 3341 (2)| IMPLANTED:| IMPLANTED: