FDA Adverse Event
Malfunction
Summary report: N
EON MINI RECHARGEABLE IPG
MDR report key: 2201506
·
Received August 4, 2011
Report
- Report Number
- 1627487-2011-04014
- Event Type
- Malfunction
- Date Received
- August 4, 2011
- Date of Event
- July 6, 2011
- Report Date
- July 6, 2011
- Manufacturer
- ST. JUDE MEDICAL - NEUROMODULATION
- Product Code
- LGW
- PMA / PMN Number
- P010032
- Removal / Correction Number
- 1627487-05242011-002-R
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NY, 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 HER SCS SYS, INCLUDING IPG ON (B)(6) 2010. THE PT REPORTED THAT HER CHARGING SYS COULD NOT LOCATE THE IPG. THE PT WAS INSTRUCTED TO FULLY RECHARGE THE CHARGER, THEN RETRY CHARGING THE IPG. ATTEMPTS TO F/U WITH THE PT HAVE NOT BEEN SUCCESSFUL. IT IS UNDETERMINED WHETHER RECHARGING THE CHARGER SOLVED HER ISSUE. NO FURTHER INFO IS AVAILABLE AT THIS TIME.
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 | 2874316 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 45 YR | Required Intervention | SCS LEAD: MODEL 3219| IMPLANTED: |