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 |