FDA Adverse Event Malfunction Summary report: N

EON MINI RECHARGEABLE IPG

MDR report key: 2182247 · Received July 12, 2011

Report

Report Number
1627487-2011-01728
Event Type
Malfunction
Date Received
July 12, 2011
Date of Event
June 13, 2011
Report Date
June 13, 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 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 HIS SCS SYSTEM, INCLUDING AN IPG, ON (B)(6) 2011. IT WAS REPORTED THAT THE PT'S CHARGING SYSTEM WAS UNABLE TO COMMUNICATE WITH THE IPG. THE CHARGER HAD ALLEGEDLY LOCATED THE IPG BUT ONLY ON AN INTERMITTENT BASIS. 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 RECHARGEABLE IPG TOTALLY IMPLANTABLE PULSE GENERATOR LGW ST. JUDE MEDICAL - NEUROMODULATION 3788 3145876

Patients

Seq Age Sex Outcome Treatment
1 49 YR Required Intervention IMPLANT:| SCS LEAD: MODEL 3186 (2)| SCS LEAD: MODEL 3186 (2)| SCS IPG: MODEL 3788| IMPLANT:| IMPLANT: