FDA Adverse Event Injury Summary report: N

CHARGING SYSTEM

MDR report key: 3032069 · Received March 26, 2013

Report

Report Number
1627487-2013-04390
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
1627487-07262012-001-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 CHARGES WERE CAPABLE OF ELEVATED HEATING. 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 2 OF 2. REF MFR REPORT: 1627487-2013-04389. 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
122957 CHARGING SYSTEM SCS CHARGING SYSTEM LGW ST JUDE MEDICAL - NEUROMODULATION 3721 3169732

Patients

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