FDA Adverse Event Injury Summary report: N

EON MINI IPG, 16-CHANNEL RECHARGEABLE

MDR report key: 2181328 · Received July 21, 2011

Report

Report Number
1627487-2011-06019
Event Type
Injury
Date Received
July 21, 2011
Date of Event
June 22, 2011
Report Date
June 22, 2011
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P010032
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
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 ((B)(6)) RECEIVED AN IPG ON (B)(6) 2011. IT WAS REPORTED THAT HIS IPG WAS EXPLANTED DUE TO AN INCREASED RECHARGE BURDEN.

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 3218926

Patients

Seq Age Sex Outcome Treatment
1 57 YR Required Intervention SCS LEAD, MODEL: 3228| IMPLANT DATE: