FDA Adverse Event
Malfunction
Summary report: N
EON MINI RECHARGEABLE IPG
MDR report key: 2113860
·
Received May 17, 2011
Report
- Report Number
- 1627487-2011-01526
- Event Type
- Malfunction
- Date Received
- May 17, 2011
- Date of Event
- April 18, 2011
- Report Date
- April 18, 2011
- Manufacturer
- ST. JUDE MEDICAL - NEUROMODULATION
- Product Code
- LGW
- PMA / PMN Number
- P010032
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MT, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
SJM HAS LIMITED INFO 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 RECEIVED HER SCS SYSTEM, INCLUDING AN IPG, ON (B)(6) 2008. IT WAS REPORTED THAT THE PT CAN NO LONGER ESTABLISH TELEMETRY BETWEEN HER IPG AND CHARGING SYSTEM. A NEW CHARGING SYSTEM WAS SENT TO THE PT; HOWEVER, IT IS CURRENTLY UNDETERMINED WHETHER THE REPLACEMENT CHARGER RESOLVED THE ISSUE. ACCORDING TO THE MANUFACTURER'S DEVICE REGISTRATION SYSTEM, THE IPG REMAINS IMPLANTED. NO FURTHER INFO 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 | 3788 | 174497 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 26 YR | Required Intervention | SCS LEAD: MODEL: 3186| IMPLANT:| SCS LEAD ANCHOR: MODEL: 1194| IMPLANT: |