FDA Adverse Event
Injury
Summary report: N
EON MINI
MDR report key: 2861031
·
Received December 3, 2012
Report
- Report Number
- 1627487-2012-13152
- Event Type
- Injury
- Date Received
- December 3, 2012
- Date of Event
- November 9, 2012
- Report Date
- November 9, 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/REMOVAL REPORTING NUMBER - 1627487-12192011-003-R, 1627487-07262012-001-C. 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
DEVICE 1 OF 2. REFERENCE MFR REPORT: 1627487-2012-13153. IT WAS REPORTED THE PT EXPERIENCED CONSTANT POCKET HEATING AT HIS IPG SITE. HE STATED THE HEATING IS MORE INTENSE WHEN HE CHARGES THE IPG. A SJM REP MADE SOME RECOMMENDATIONS ON CHARGING TECHNIQUE AND A REPLACEMENT CHARGER WAS SENT TO THE PT. NO FURTHER INFO 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 | 2887049 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 50 YR | Required Intervention | IMPLANT DATE:| SCS LEAD: MODEL 3228 |