FDA Adverse Event
Injury
Summary report: N
EON MINI
MDR report key: 3052341
·
Received April 4, 2013
Report
- Report Number
- 1627487-2013-12450
- Event Type
- Injury
- Date Received
- April 4, 2013
- Date of Event
- March 8, 2013
- Report Date
- March 15, 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 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
IT WAS REPORTED THE PT LOST STIMULATION AND THE CHARGER AND PROGRAMMER ARE UNABLE TO COMMUNICATE WITH THE IPG. THE SJM REPRESENTATIVE INTERROGATED THE SYSTEM AND WAS UNABLE TO ESTABLISH COMMUNICATION WITH EXTERNAL DEVICES. FOLLOW-UP DETERMINED THE IPG WAS EXPLANTED AND REPLACED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 137795 | EON MINI | SCS IPG | LGW | ST. JUDE MEDICAL - NEUROMODULATION | 3788 | 3504574 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 47 YR | Required Intervention | SCS LEAD: MODEL 3219| IMPLANT DATE: |