FDA Adverse Event Malfunction Summary report: N

PULSE GEN MODEL 102

MDR report key: 2201315 · Received August 3, 2011

Report

Report Number
1644487-2011-01775
Event Type
Malfunction
Date Received
August 3, 2011
Date of Event
July 8, 2011
Report Date
July 8, 2011
Manufacturer
CYBERONICS, INC.
Product Code
LYJ
PMA / PMN Number
P970003
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

REPORTER INDICATED A PT'S VNS GENERATOR WAS BELIEVED TO BE AT PREMATURE END OF SERVICE AND THE PT WAS ALSO EXPERIENCING AN INCREASE IN SEIZURES. THE PT HAD VNS GENERATOR REPLACEMENT PERFORMED, AND THE EXPLANTED GENERATOR HAS BEEN RETURNED AND IS PENDING ANALYSIS. A BATTERY LIFE ESTIMATE WITH AVAILABLE DATA YIELDED 0.97 YEARS REMAINING. ATTEMPTS FOR FURTHER INTO ARE IN PROGRESS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PULSE GEN MODEL 102 LYJ CYBERONICS, INC. 102 200801

Patients

Seq Age Sex Outcome Treatment
1 10 YR Required Intervention