FDA Adverse Event Injury Summary report: N

PULSE GEN MODEL 102

MDR report key: 2172671 · Received July 20, 2011

Report

Report Number
1644487-2011-01626
Event Type
Injury
Date Received
July 20, 2011
Date of Event
February 1, 2011
Report Date
June 23, 2011
Manufacturer
CYBERONICS, INC.
Product Code
LYJ
PMA / PMN Number
P970003
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

IT WAS REPORTED BY A NURSE THAT A VNS PT WAS NOT ABLE TO TOLERATE VNS STIMULATION AND HER DEVICE WAS TURNED OFF IN (B)(6) 2011. THERE HAS NOT BEEN ANY SEIZURE CHANGE SINCE DISABLEMENT OF THE DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PULSE GEN MODEL 102 LYJ CYBERONICS, INC. 102 009771

Patients

Seq Age Sex Outcome Treatment
1 15 YR Required Intervention