FDA Adverse Event Injury Summary report: N

EON MINI

MDR report key: 3110750 · Received May 9, 2013

Report

Report Number
1627487-2013-03630
Event Type
Injury
Date Received
May 9, 2013
Date of Event
April 16, 2013
Report Date
April 17, 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
VA, 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

DEVICE 1 OF 2. REFERENCE MFR REPORT: 1627487-2013-03631. THE PATIENT REPORTED EXPERIENCING UNCOMFORTABLE HEATING AT HER SCS IPG POCKET SITE THE DAY AFTER CHARGING. THE PATIENT ALSO REPORTED SHE USED AN ICE PACK TO ALLEVIATE THE ISSUE. ADDITIONALLY, A REPLACEMENT CHARGING SYSTEM WAS SENT TO THE PATIENT. FOLLOW-UP IDENTIFIED THE PATIENT HAS NOT EXPERIENCED HEATING WHILE CHARGING; HOWEVER, SHE EXPERIENCED BURNING AT HER SCS IPG POCKET SITE WHILE USING SYSTEM STIMULATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
202617 EON MINI SCS IPG LGW ST. JUDE MEDICAL- NEUROMODULATION 3788 3776223

Patients

Seq Age Sex Outcome Treatment
1 64 YR Required Intervention SCS ANCHOR: MODEL 1194 (2)| IMPLANT DATE: