FDA Adverse Event Malfunction Summary report: N

RESTORE SENSOR

MDR report key: 3080295 · Received April 26, 2013

Report

Report Number
3004209178-2013-06956
Event Type
Malfunction
Date Received
April 26, 2013
Report Date
April 8, 2013
Manufacturer
MEDTRONIC MED REL MEDTRONIC PUERTO RICO
Product Code
LGW
PMA / PMN Number
P840001
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

CONCOMITANT PRODUCTS: PRODUCT ID 3777-60, SERIAL# (B)(4), IMPLANTED: (B)(6) 2012, PRODUCT TYPE LEAD; PRODUCT ID 37754, SERIAL# (B)(4), PRODUCT TYPE RECHARGER; PRODUCT ID 3708160, SERIAL# (B)(4), IMPLANTED: (B)(6) 2012, PRODUCT TYPE EXTENSION; PRODUCT ID 3708160, SERIAL# (B)(4), IMPLANTED: (B)(6) 2012-, PRODUCT TYPE EXTENSION; PRODUCT ID 3777-60, SERIAL# (B)(4), IMPLANTED: (B)(6) 2012, PRODUCT TYPE LEAD; PRODUCT ID 37746, SERIAL# (B)(4), PRODUCT TYPE PROGRAMMER, PATIENT. (B)(4).

Description of Event or Problem · 1

IT WAS NOTED THAT THE PATIENT WOULD JUST BE STANDING IN THE UPRIGHT POSITION AND THEIR STIMULATION WILL CUT OUT. WHEN THE PATIENT CHECKED THEIR DEVICE WITH THEIR PATIENT PROGRAMMER IT SHOWED THE DEVICE WAS STILL ON.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT HAD INTERMITTENT LOSS OF STIMULATION. IT WAS NOTED THAT IT WAS UNKNOWN WHETHER THE INTERMITTENT LOSS OF STIMULATION WAS RELATED TO POSITION. IT WAS NOTED THAT PROGRAMMING PARAMETERS WERE ALSO UNKNOWN. TWO WEEKS LATER, IT WAS REPORTED THAT IMPEDANCES WERE ALL NORMAL. IT WAS NOTED THAT THE PATIENT'S PROGRAMMING WAS CHANGED 'A LITTLE' AND THE PATIENT WAS HAPPY WITH IT. IT WAS REPORTED THAT THE STIMULATION REMAINED ON WHEN THE PATIENT WAS STANDING STILL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
181028 RESTORE SENSOR STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW MEDTRONIC MED REL MEDTRONIC PUERTO RICO 37714

Patients

Seq Age Sex Outcome Treatment
1