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: