BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EON MINI

    MDR report key: 2921770 · Received January 14, 2013

    Report

    Report Number
    1627487-2013-13075
    Event Type
    Injury
    Date Received
    January 14, 2013
    Date of Event
    December 22, 2012
    Report Date
    December 22, 2012
    Manufacturer
    ST. JUDE MEDICAL - NEUROMODULATION
    Product Code
    LGW
    PMA / PMN Number
    P010032
    Removal / Correction Number
    1627487-07262012-002-R
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    THIS IPG SERIAL NUMBER WAS INCLUDED IN A FIELD ADVISORY. SJM HAS LIMITED INFORMATION 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

    THE PT REPORTED, HE WAS FEELING PAIN AT HIS IPG IMPLANT SITE. THE PT STATED, THE PAIN WAS NOT AFFECTED BY TURNING ON, OFF, UP OR DOWN THE STIMULATION. FOLLOW-UP INFORMATION IDENTIFIED THE PT WENT TO THE EMERGENCY ROOM. THE REPORTED PAIN THE PT WAS FEELING AT HIS IPG SITE WAS DUE TO A PULLED MUSCLE. THE PT WAS TREATED WITH MEDICATION WHICH RESOLVED THE ISSUE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    20546 EON MINI SCS IPG LGW ST. JUDE MEDICAL - NEUROMODULATION 3788 3359256

    Patients

    Seq Age Sex Outcome Treatment
    1 79 YR Required Intervention SCS ANCHOR: MODEL 1194 (2)| IMPLANT DATE:| SCS LEAD: MODEL 3186 (2)| IMPLANT DATE: