BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EON MINI

    MDR report key: 2903063 · Received January 3, 2013

    Report

    Report Number
    1627487-2013-15006
    Event Type
    Injury
    Date Received
    January 3, 2013
    Date of Event
    December 6, 2012
    Report Date
    December 6, 2012
    Manufacturer
    ST. JUDE MEDICAL - NEUROMODULATION
    Product Code
    LGW
    PMA / PMN Number
    P010032
    Removal / Correction Number
    1627487-05242011-002-R
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    NOT APPLICABLE

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    2053 EON MINI SCS IPG LGW ST. JUDE MEDICAL - NEUROMODULATION 3788 2849290

    Patients

    Seq Age Sex Outcome Treatment
    1 60 YR Required Intervention IMPLANT DATE: | IMPLANT DATE: | IMPLANT DATE: | SCS EXTENSION: MODEL 3383 (2)| SCS LEAD: MODEL 3186| SCS LEAD: MODEL 3219