FDA Adverse Event Injury Summary report: N

UNKNOWN IMPLANTABLE NEUROSTIMULATOR

MDR report key: 2913915 · Received January 14, 2013

Report

Report Number
3007566237-2013-00151
Event Type
Injury
Date Received
January 14, 2013
Report Date
December 21, 2012
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
MRU
PMA / PMN Number
H020007
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

SUPPLEMENTAL SUBMITTED TO CORRECT CONCLUSION CODES.

Description of Event or Problem · 1

IT WAS REPORTED THAT A DOCTOR HAD RE-OPERATED ON 45 PATIENTS SINCE 1995, "SOME" DUE TO MOVEMENT OF THE LEAD. NO FURTHER INFORMATION WAS REPORTED.

Description of Event or Problem · 1

ADDITIONAL REVIEW INDICATED THAT THE PATIENT HAD TO BE RE-OPERATED ON DUE TO LEAD MOVEMENT OR INFECTION. IT WAS UNCLEAR WHICH OF THE TWO PERTAINED TO THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
19894 UNKNOWN IMPLANTABLE NEUROSTIMULATOR IMPLANTED SUBCORTICAL ELECTRICAL STIMULATOR (MOTOR DISORDERS) MRU MEDTRONIC NEUROMODULATION NEU_INS_STIMULATOR

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention