FDA Adverse Event Injury Summary report: N

CHARGING SYSTEM

MDR report key: 3110869 · Received May 9, 2013

Report

Report Number
1627487-2013-04574
Event Type
Injury
Date Received
May 9, 2013
Date of Event
April 17, 2013
Report Date
April 17, 2013
Manufacturer
ST JUDE MEDICAL - NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P010032
Removal / Correction Number
1627487-07262012-001-C
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS CHARGER MODEL WAS ASSOCIATED WITH A FIELD CORRECTION. CORRECTIVE AND PREVENTIVE ACTION (CAPA) INVESTIGATION WAS PERFORMED. RESULTS - POCKET HEATING WAS CONFIRMED. THE INVESTIGATION FOR CAPA (B)(4) ASSOCIATED WITH HEATING WHILE CHARGING (POCKET HEATING) CONCLUDED THAT THE CHARGER WAS CAPABLE OF TRANSFERRING ENERGY TO THE IPG AT A RATE THAT WOULD CAUSE HEATING OF THE IPG AND/OR CHARGING WAND OF SUFFICIENT ELEVATED TEMPERATURE TO CAUSE PAIN AND BURNS. THE HEATING WHILE CHARGING WAS DETERMINED TO BE EXACERBATED BY OFF-AXIS CHARGING OF SHALLOW IMPLANTED IPGS AND THAT ALL CHARGES WERE CAPABLE OF ELEVATED HEATING. SJM HAS LIMITED INFO RELATED TO THE PATIENT'S MEDICAL HISTORY AND IS UNABLE TO FORM AN OPINION AS TO THE RELEVANCY OF THE PATIENT'S HISTORY TO THE EVENT REPORTED. SJM DEFERS TO THE PATIENT'S PHYSICIAN REGARDING MEDICAL HISTORY.

Description of Event or Problem · 1

DEVICE 3 OF 3. REF MFR REPORTS: 1627487-2013-04572, 1627487-2013-04573. IT WAS REPORTED THE PT WAS EXPERIENCING HEATING WHILE RECHARGING THE IPG WITH THE CHARGING SYSTEM. IN ADDITION, THE PT REPORTED THE IPG WAS SUPERFICIAL, AND WAS CAUSING THE AREA AROUND THE IPG TO BE UNCOMFORTABLE. THE PT REPORTED WHEN HE WEARS JEANS, THEY RUB ON THE IPG SITE. IT WAS ALSO REPORTED THE PT HAD NOT RECEIVED EFFECTIVE STIMULATION RELIEF, AND REPROGRAMMING WAS UNABLE TO RESOLVE THE ISSUE. THE PT HAD REQUESTED FOR THE SCS SYSTEM TO BE REMOVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
202556 CHARGING SYSTEM SCS CHARGING SYSTEM LGW ST JUDE MEDICAL - NEUROMODULATION 3721 3503164

Patients

Seq Age Sex Outcome Treatment
1 47 YR Required Intervention