FDA Adverse Event Injury Summary report: N

EON MINI

MDR report key: 2993948 · Received March 1, 2013

Report

Report Number
1627487-2013-02317
Event Type
Injury
Date Received
March 1, 2013
Date of Event
August 7, 2012
Report Date
February 7, 2013
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATON
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 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

IT WAS REPORTED THE PT HAS EXPERIENCED AN ELECTRICAL/BURNING SENSATION AT HER IPG SITE FOR APPROXIMATELY 6 MONTHS. THE PT ALLEGEDLY WAS UNSURE WHETHER THIS OCCURS WHEN STIMULATION IS ON OR OFF. IT WAS REPORTED THE SJM REP WILL MEET WITH THE PT TO INVESTIGATE THE ISSUE. NO FURTHER INFO IS AVAILABLE AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
89252 EON MINI SCS IPG LGW ST. JUDE MEDICAL - NEUROMODULATON 3788 3625636

Patients

Seq Age Sex Outcome Treatment
1 58 YR Required Intervention IMPLANT DATE:| SCS LEAD: MODEL 3186 (2)