FDA Adverse Event
Injury
Summary report: N
EON MINI
MDR report key: 2885046
·
Received December 18, 2012
Report
- Report Number
- 1627487-2012-06968
- Event Type
- Injury
- Date Received
- December 18, 2012
- Date of Event
- November 28, 2012
- Report Date
- November 28, 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 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
ON (B)(6) 2012, THE PT WENT TO THE EMERGENCY ROOM DUE TO THE IPG SITE OPENING UP AND THE IPG BEING EXPOSED. THE PHYSICIAN DECIDED TO REMOVE THE STAPLES AND SUTURE THE POCKET SITE. CULTURES WERE TAKEN AND NO SIGNS OF INFECTION WERE FOUND. THE PT WAS GIVEN ANTIBIOTICS AS A PRECAUTION. ON (B)(6) 2012, THE PATIENT MET WITH HER DOCTOR DUE TO THE WOUND OPENING AGAIN. THE DOCTOR IRRIGATED THE WOUND AND CLOSED IT. AGAIN, NO SIGNS OF INFECTION WERE FOUND. THE PT WILL FOLLOW-UP WITH HER DOCTOR ON A LATER DATE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | EON MINI | SCS IPG | LGW | ST. JUDE MEDICAL NEUROMODULATION | 3788 | 3834301 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 50 YR | Hospitalization| R | IMPLANT:| SCS LEADS: MODEL 3186(2)| IMPLANT:| SCS ANCHORS: MODEL 1194(2) |