FDA Adverse Event Injury Summary report: N

EON RECHARGEABLE IPG

MDR report key: 2181342 · Received July 21, 2011

Report

Report Number
1627487-2011-01776
Event Type
Injury
Date Received
July 21, 2011
Date of Event
June 21, 2011
Report Date
June 23, 2011
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P010032
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AS
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 RECEIVED HER SCS SYSTEM, INCLUDING AN IPG, ON (B)(6) 2010. IT WAS REPORTED THAT THE PT (B)(6) RECEIVED INEFFECTIVE STIMULATION. THE PHYSICIAN EXPLANTED THE PT'S SYSTEM ON (B)(6) 2011. NO FURTHER INFO IS AVAILABLE AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EON RECHARGEABLE IPG TOTALLY IMPLANTABLE PULSE GENERATOR LGW ST. JUDE MEDICAL - NEUROMODULATION 3716 2789910

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention