FDA Adverse Event
Injury
Summary report: N
EON MINI IPG, 16-CHANNEL RECHARGEABLE
MDR report key: 2133576
·
Received June 16, 2011
Report
- Report Number
- 1627487-2011-00817
- Event Type
- Injury
- Date Received
- June 16, 2011
- Date of Event
- May 13, 2011
- Report Date
- May 19, 2011
- Manufacturer
- ST. JUDE MEDICAL - NEUROMODULATION
- Product Code
- LGW
- PMA / PMN Number
- P010032
- Removal / Correction Number
- 1627487-05242011-002-R
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- SZ
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
THIS IPG SERIAL NUMBER WAS INCLUDED IN A FIELD ADVISORY. 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 (B)(6) WAS IMPLANTED WITH AN IPG ON (B)(6) 2010. IT WAS REPORTED THAT THE PT LOST STIMULATION AND WAS UNABLE TO ESTABLISH COMMUNICATION WITH THE IPG USING THE CHARGING SYSTEM AND TWO PROGRAMMERS. SURGICAL INTERVENTION WAS UNDERTAKEN TO REPLACE THE PT'S IPG, AND EFFECTIVE STIMULATION WAS RECAPTURED. NO FURTHER ISSUES WERE REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | EON MINI IPG, 16-CHANNEL RECHARGEABLE | TOTALLY IMPLANTABLE PULSE GENERATOR | LGW | ST. JUDE MEDICAL - NEUROMODULATION | 3788 | 2836744 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 74 YR | Required Intervention | SCS LEADS: MODEL 3183| IMPLANTED: |