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: