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: