FDA Adverse Event Injury Summary report: N

CHARGING SYSTEM

MDR report key: 3012213 · Received March 12, 2013

Report

Report Number
1627487-2013-06047
Event Type
Injury
Date Received
March 12, 2013
Date of Event
February 19, 2013
Report Date
February 19, 2013
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P010032
Removal / Correction Number
1627487-07262012-001-C
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS CHARGER MODEL WAS ASSOCIATED WITH A FIELD CORRECTION. CORRECTIVE AND PREVENTIVE ACTION (CAPA) INVESTIGATION WAS PERFORMED. RESULTS: POCKET HEATING WAS CONFIRMED. THE INVESTIGATION FOR (B)(4) ASSOCIATED WITH HEATING WHILE CHARGING (POCKET HEATING) CONCLUDED THAT THE CHARGER WAS CAPABLE OF TRANSFERRING ENERGY TO THE IPG AT A RATE THAT WOULD CAUSE HEATING OF THE IPG AND/OR CHARGING WAND OF SUFFICIENT ELEVATED TEMPERATURE TO CAUSE PAIN AND BURNS. THE HEATING WHILE CHARGING WAS DETERMINED TO BE EXACERBATED BY OFF-AXIS CHARGING OF SHALLOW IMPLANTED IPGS AND THAT ALL CHARGERS WERE CAPABLE OF ELEVATED HEATING. SJM HAS LIMITED INFORMATION RELATED TO THE PT'S MEDICAL HISTORY AND IS UNABLE TO FORM AN OPINION AS TO THE RELEVANCY OF THE PT'S HISTORY TO THE EVENT REPORTED. SJM DEFERS TO THE PT'S PHYSICIAN REGARDING MEDICAL HISTORY.

Description of Event or Problem · 1

DEVICE 2 OF 2. REFERENCE MFR REPORT: 1627487-2013-06046. IT WAS REPORTED THE PT WAS EXPERIENCING POCKET HEATING WHILE CHARGING. THE PT THEN STOPPED CHARGING AND USING HER SYSTEM, BUT DID NOT INFORM ANYONE AT THE TIME. THE IPG IS BELIEVED TO THE PAST THE POINT OF RECHARGE DUE TO THE PROLONGED PERIOD WITHOUT RECHARGING. THE PT WAS REQUESTED TO HAVE HER IPG REPLACED WITH A NON-RECHARGEABLE IPG. FOLLOW-UP INDICATES THE PT HAD HER RECHARGEABLE IPG REPLACED ON (B)(6) 2013 WITH A NON-RECHARGEABLE IPG.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
104467 CHARGING SYSTEM SCS CHARGING SYSTEM LGW ST. JUDE MEDICAL - NEUROMODULATION 3721 172426

Patients

Seq Age Sex Outcome Treatment
1 35 YR Required Intervention IMPLANT DATE:| SCS LEAD: MODEL 3186