FDA Adverse Event
Injury
Summary report: N
EON MINI
MDR report key: 3032528
·
Received April 1, 2013
Report
- Report Number
- 1627487-2013-13478
- Event Type
- Injury
- Date Received
- April 1, 2013
- Date of Event
- January 28, 2013
- Report Date
- March 7, 2013
- Manufacturer
- ST JUDE MEDICAL NEUROMODULATION
- Product Code
- LGW
- PMA / PMN Number
- P010032
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TX, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
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
IT WAS REPORTED THE PATIENT WAS FEELING HEAT AT HIS IPG POCKET SITE AND WOULD LIKE HIS SYSTEM EXPLANTED. NO FURTHER INFO IS AVAILABLE AT THIS TIME.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 131367 | EON MINI | SCS IPG | LGW | ST JUDE MEDICAL NEUROMODULATION | 3788 | 3792809 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 33 YR | Required Intervention | SCS ANCHOR: MODEL 1192 (2)| IMPLANT DATE:| IMPLANT DATE:| SCS LEAD: MODEL 3186 (2) |