FDA Adverse Event Injury Summary report: N

EON MINI

MDR report key: 2980044 · Received February 22, 2013

Report

Report Number
1627487-2013-13355
Event Type
Injury
Date Received
February 22, 2013
Date of Event
February 1, 2013
Report Date
February 1, 2013
Manufacturer
ST JUDE MEDICAL - NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P010032
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

SJM HAS LIMITED INFO 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 1 OF 3. REF MFR REPORT: 1627487-2013-13356 & 1627487-2013-13357. IT WAS REPORTED, THE PT'S ENTIRE SCS SYSTEM WAS EXPLANTED. NO FURTHER INFO IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
77664 EON MINI SCS IPG LGW ST JUDE MEDICAL - NEUROMODULATION 3788 3597323

Patients

Seq Age Sex Outcome Treatment
1 33 YR Required Intervention