BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EON MINI

    MDR report key: 3032063 · Received March 26, 2013

    Report

    Report Number
    1627487-2013-04389
    Event Type
    Injury
    Date Received
    March 26, 2013
    Date of Event
    June 6, 2012
    Report Date
    March 6, 2013
    Manufacturer
    ST JUDE MEDICAL - NEUROMODULATION
    Product Code
    LGW
    PMA / PMN Number
    P010032
    Removal / Correction Number
    1627487-05242011-002-R
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    RECALL NUMBERS - 1627487-12192011-003-R; 1627487-07262012-002-R AND 1627487-07262012-001-C. THIS IPG SERIAL NUMBER WAS INCLUDED IN A FIELD ADVISORIES AND A FIELD CORRECTION. SJM HAS LIMITED INFO 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

    DEVICE 1 OF 2. REF MFR REPORT: 1627487-2013-04390. IT WAS REPORTED THE PT HAD STOPPED CHARGING HER IPG MANY MONTHS AGO DUE TO HEATING WHILE USING THE CHARGING SYSTEM. THE PT REPORTED THE IPG WAS UNABLE TO COMMUNICATE WITH EXTERNAL DEVICES. THE PT DID NOT WANT A REPLACEMENT CHARGING SYSTEM. REF MFR REPORT: 1627487-2012-04870 FOR THE LEAD ISSUE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    122956 EON MINI SCS IPG LGW ST JUDE MEDICAL - NEUROMODULATION 3788 2822627

    Patients

    Seq Age Sex Outcome Treatment
    1 52 YR Required Intervention IMPLANT DATE:| SCS LEAD: MODEL 3186 (2)