FDA Adverse Event Malfunction Summary report: N

EON MINI IMPLANTABLE PULSE GENERATOR

MDR report key: 2180641 · Received May 5, 2011

Report

Report Number
1627487-2011-02546
Event Type
Malfunction
Date Received
May 5, 2011
Date of Event
April 8, 2011
Report Date
April 8, 2011
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P010032
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

SJM HAS LIMITED INFORMATION 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 REC'D HIS/HER SCS SYSTEM, INCLUDING AN IPG, ON (B)(6) 2010. IT WAS REPORTED THE PT CAN NO LONGER ESTABLISH TELEMETRY BETWEEN HIS IPG AND CHARGING SYSTEM. A NEW CHARGING SYSTEM WAS SENT TO THE PT. ATTEMPTS TO OBTAIN ADD'L INFO REGARDING THE PT'S CONDITION AND/OR DEVICE STATUS WERE UNSUCCESSFUL. ACCORDING TO THE MFR'S DEVICE REGISTRATION SYSTEM, THE IPG REMAINS IMPLANTED. NO FURTHER PT COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EON MINI IMPLANTABLE PULSE GENERATOR TOTALLY IMPLANTABLE PULSE GENERATOR LGW ST. JUDE MEDICAL - NEUROMODULATION 3788 3175243

Patients

Seq Age Sex Outcome Treatment
1 52 YR Required Intervention IMPLANT:| SCS ANCHOR: MODEL 1192| IMPLANT:| SCS LEAD: MODEL 3186 (2)