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 |