BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EON MINI

    MDR report key: 2820161 · Received November 2, 2012

    Report

    Report Number
    1627487-2012-02606
    Event Type
    Injury
    Date Received
    November 2, 2012
    Date of Event
    October 9, 2012
    Report Date
    October 9, 2012
    Manufacturer
    ST. JUDE MEDICAL - NEUROMODULATION
    Product Code
    LGW
    PMA / PMN Number
    P010032
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    SJM HAS LIMITED INFORMATION 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

    IT WAS REPORTED THE PT DEVELOPED MENINGITIS AND THE INFECTION WAS LOCATED AT THE IPG POCKET SITE. THE PHYSICIAN CONSEQUENTLY REMOVED THE PT'S SCS SYSTEM. THE PT WAS TREATED WITH INTRAVENOUS ANTIBIOTICS. IT WAS REPORTED THE PT IS CURRENTLY IN A SKILLED NURSING FACILITY. NO FURTHER INFORMATION IS AVAILABLE AT THIS TIME.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 EON MINI SCS IPG LGW ST. JUDE MEDICAL - NEUROMODULATION 3788 3724226

    Patients

    Seq Age Sex Outcome Treatment
    1 73 YR Hospitalization| R IMPLANT DATE:| SCS ANCHOR: MODEL 1192 (2)| IMPLANT DATE:| SCS LEAD: MODEL 3186 (2)