FDA Adverse Event Injury Summary report: N

CHARGING SYSTEM

MDR report key: 2970989 · Received February 15, 2013

Report

Report Number
1627487-2013-01175
Event Type
Injury
Date Received
February 15, 2013
Date of Event
January 22, 2013
Report Date
January 22, 2013
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P010032
Removal / Correction Number
1627487-07262012-001-C
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS CHARGER MODEL WAS ASSOCIATED WITH A FIELD CORRECTION. MANUFACTURER'S EVALUATION: CORRECTIVE AND PREVENTIVE ACTION (CAPA) INVESTIGATION WAS PERFORMED. EVALUATION CODES: RESULT: POCKET HEATING WAS CONFIRMED. THE INVESTIGATION FOR (B)(4) ASSOCIATED WITH HEATING WHILE CHARGING (POCKET HEATING) CONCLUDED THAT THE CHARGER WAS CAPABLE OF TRANSFERRING ENERGY TO THE IPG AT A RATE THAT WOULD CAUSE HEATING OF THE IPG AND/OR CHARGING WAND OF SUFFICIENT ELEVATED TEMPERATURE TO CAUSE PAIN AND BURNS. THE HEATING WHILE CHARGING WAS DETERMINED TO BE EXACERBATED BY OFF-AXIS CHARGING OF SHALLOW IMPLANTED IPGS AND THAT ALL CHARGERS WERE CAPABLE OF ELEVATED HEATING. SJM HAS LIMITED INFORMATION RELATED TO THE PATIENT'S MEDICAL HISTORY AND IS UNABLE TO FORM AN OPINION AS TO THE RELEVANCY OF THE PATIENT'S HISTORY TO THE EVENT REPORTED. SJM DEFERS TO THE PATIENT'S PHYSICIAN REGARDING MEDICAL HISTORY.

Description of Event or Problem · 1

DEVICE 2 OF 2. REFERENCE MFR REPORT: 1627487-2013-1172. IT WAS REPORTED THE PATIENT'S IPG IS VERY CLOSE TO HER SKIN, AND IT CAUSES HER SOME DISCOMFORT. HER PHYSICIAN STATED THE PATIENT HAS A POCKET AREA NEAR THE IPG THAT IS CAUSING THE PAIN AND IT WILL TAKE SOME TIME TO COMPLETELY HEAL FROM THE PROCEDURE. THE PATIENT WAS TREATED WITH PAIN MEDICATION AND WILL FOLLOW-UP WITH HER PHYSICIAN IN (B)(6) 2013. IT WAS ALSO REPORTED THE PATIENT EXPERIENCED A HEATING SENSATION WHILE CHARGING HER IPG. THE HEATING ISSUE WAS RESOLVED BY REPLACING HER CHARGER WITH A NEW LE CHARGER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
69501 CHARGING SYSTEM SCS CHARGER LGW ST. JUDE MEDICAL - NEUROMODULATION 3721 3797645

Patients

Seq Age Sex Outcome Treatment
1 47 YR Required Intervention SCS LEAD: MODEL 3186 (2)| IMPLANT DATE: