BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EON

    MDR report key: 2973667 · Received February 19, 2013

    Report

    Report Number
    1627487-2013-04205
    Event Type
    Injury
    Date Received
    February 19, 2013
    Date of Event
    October 29, 2012
    Report Date
    January 28, 2013
    Manufacturer
    ST. JUDE MEDICAL - NEUROMODULATION
    Product Code
    LGW
    PMA / PMN Number
    P010032
    Removal / Correction Number
    1627487-07262012-001-C
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    THIS IPG SERIAL NUMBER WAS INCLUDED IN A FIELD CORRECTION. 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

    DEVICE 1 OF 2. REFERENCE MFR REPORT: 1627487-2013-04206. IT WAS REPORTED THE PT WAS EXPERIENCING PAIN AT THE IPG SITE. THE SJM REPRESENTATIVE REPORTED THE PT WAS EXPERIENCING UNCOMFORTABLE IPG POCKET HEATING WHILE RECHARGING THE IPG. THE PT WAS ADVISED OF CHARGING RECOMMENDATIONS. FOLLOW UP INDICATED THE HEATING ISSUE WAS RESOLVED WITH THE CHARGING RECOMMENDATIONS. IT WAS REPORTED THE PT DID NOT WANT TO PURSUE SURGICAL INTERVENTION TO ADDRESS THE PAIN AT THE IPG SITE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    72705 EON SCS IPG LGW ST. JUDE MEDICAL - NEUROMODULATION 3716 3224692

    Patients

    Seq Age Sex Outcome Treatment
    1 74 YR Required Intervention SCS LEAD: MODEL 3228| IMPLANT DATE: