FDA Adverse Event Injury Summary report: N

EON MINI

MDR report key: 2821173 · Received October 25, 2012

Report

Report Number
1627487-2012-03584
Event Type
Injury
Date Received
October 25, 2012
Date of Event
October 1, 2012
Report Date
October 1, 2012
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P010032
Removal / Correction Number
1627487-12192011-003-R
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS IPG SERIAL NUMBER WAS INCLUDED IN A FIELD ADVISORY. SJM HAS LIMITED INFORMATION RELATED TO THE PATIENT'S MEDICAL HISTORY AND IS UNABLE TO FORM AN OPINION AS TO THE RELEVANCY OF THE PATIENT'S HISTORY TO THE EVENT REPORTED. SJM DEFERS TO THE PATIENT'S PHYSICIAN REGARDING MEDICAL HISTORY.

Description of Event or Problem · 1

IT WAS REPORTED THE PATIENT IS EXPERIENCING INTERMITTENT HEATING AT HER SCS IPG POCKET SITE IN ADDITIONAL TO HAVING PROBLEMS CHARGING HER SCS IPG. THE HEATING AND CHARGING ISSUES ARE UNRELATED. FOLLOW-UP IS PENDING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EON MINI SCS IPG LGW ST. JUDE MEDICAL - NEUROMODULATION 3788 3139296

Patients

Seq Age Sex Outcome Treatment
1 45 YR Required Intervention IMPLANT DATE:| SCS LEAD: MODEL 3228