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: