FDA Adverse Event
Injury
Summary report: N
EON MINI
MDR report key: 3012198
·
Received March 13, 2013
Report
- Report Number
- 1627487-2013-15346
- Event Type
- Injury
- Date Received
- March 13, 2013
- Date of Event
- February 20, 2013
- Report Date
- February 20, 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 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 PATIENT REQUESTED A NON-RECHARGEABLE IPG BE IMPLANTED AS PART OF HER SCS SYSTEM. THE PHYSICIAN IMPLANTED THE PATIENT WITH A RECHARGEABLE IPG AND POSTOPERATIVELY THE PATIENT AGAIN INDICATED SHE WANTED A NON-RECHARGEABLE IPG. THE PHYSICIAN EXPLANTED AND REPLACED THE PATIENT'S RECHARGEABLE IPG WITH A NON-RECHARGEABLE IPG.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 106602 | EON MINI | SCS IPG | LGW | ST. JUDE MEDICAL - NEUROMODULATION | 3788 | UNKNOWN |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 45 YR | Required Intervention | IMPLANT DATE:| SCS ANCHOR: MODEL 1192 (2)| SCS LEAD: MODEL 3189 (2)| IMPLANT DATE: |