FDA Adverse Event Injury Summary report: N

CHARGING SYSTEM

MDR report key: 3031961 · Received March 28, 2013

Report

Report Number
1627487-2013-15412
Event Type
Injury
Date Received
March 28, 2013
Date of Event
March 5, 2013
Report Date
March 5, 2013
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION DIVISION
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
OH, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS CHARGER MODEL WAS ASSOCIATED WITH A FIELD CORRECTION. MFR'S EVAL: CORRECTIVE AND PREVENTIVE ACTION (CAPA) INVESTIGATION WAS PERFORMED. EVAL, RESULTS: POCKET HEATING WAS CONFIRMED. THE INVESTIGATION FOR CAPA (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 INFO 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: 1627487-2013-15411. IT WAS REPORTED THE PT EXPERIENCE HEATING WHILE CHARGING HER IPG. THE SJM REP REVIEWED THE CHARGING GUIDELINES WITH THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
127522 CHARGING SYSTEM SCS CHARGING SYSTEM LGW ST. JUDE MEDICAL - NEUROMODULATION DIVISION 3701 117050

Patients

Seq Age Sex Outcome Treatment
1 60 YR Required Intervention SCS LEAD: MODEL 3214| IMPLANT DATE:| SCS EXTENSION: MODEL 3383 (2)| IMPLANT DATE: