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: |