FDA Adverse Event Malfunction Summary report: N

EON MINI RECHARGEABLE IPG

MDR report key: 2190900 · Received July 19, 2011

Report

Report Number
1627487-2011-01770
Event Type
Malfunction
Date Received
July 19, 2011
Date of Event
June 21, 2011
Report Date
June 21, 2011
Manufacturer
ST JUDE MED - NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P010032
Removal / Correction Number
1627487-05242011-002-R
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS IPG SERIAL NUMBER IA INCLUDED IN A FIELD ADVISORY. 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) 2008. IT WAS REPORTED THAT THE PT'S IPG IS TAKING LONGER TO CHARGE. A NEW CHARGER 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 RECHARGEABLE IPG TOTALLY IMPLANTABLE PULSE GENERATOR LGW ST JUDE MED - NEUROMODULATION 3788 173095

Patients

Seq Age Sex Outcome Treatment
1 54 YR Required Intervention IMPLANT:| SCS LEAD, MODEL: 3186