FDA Adverse Event Injury Summary report: N

EON MINI

MDR report key: 2831909 · Received November 9, 2012

Report

Report Number
1627487-2012-11637
Event Type
Injury
Date Received
November 9, 2012
Date of Event
July 15, 2012
Report Date
October 15, 2012
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P010032
Removal / Correction Number
1627487-05242011-002-R
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

CORRECTION: 1627487-07262012-002-R. THIS IPG SERIAL NUMBER WAS INCLUDED IN FIELD ADVISORIES. 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 HAD NOT CHARGED THE IPG FOR 3 WEEKS, AND WAS UNABLE TO ESTABLISH COMMUNICATION WITH EXTERNAL DEVICES ONCE ATTEMPTED. THE SJM REPRESENTATIVE MET WITH THE PATIENT AND CONFIRMED THE ISSUE. FOLLOW UP IDENTIFIED THE PHYSICIAN REPLACED THE IPG.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EON MINI SCS IPG LGW ST. JUDE MEDICAL - NEUROMODULATION 3788 172253

Patients

Seq Age Sex Outcome Treatment
1 59 YR Required Intervention SCS LEAD, MODEL 3244| IMPLANT DATE:| SCS ANCHOR, MODEL 1194| IMPLANT DATE: