FDA Adverse Event Injury Summary report: N

PULSE GEN MODEL 105

MDR report key: 3122047 · Received May 21, 2013

Report

Report Number
1644487-2013-01489
Event Type
Injury
Date Received
May 21, 2013
Date of Event
March 18, 2013
Report Date
April 26, 2013
Manufacturer
CYBERONICS, INC.
Product Code
LYJ
PMA / PMN Number
P970003
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

CLINIC NOTES WERE RECEIVED IN REGARDS TO A VNS PATIENT. THE PATIENT WAS SEEN (B)(6) 2013 AND IT WAS REPORTED THAT HE HAD 2 SEIZURES TODAY FIVE MINUTES APART AND THAT HE COULD NOT SLEEP FOR THE PAST 2 DAYS DUE TO STRESS HOWEVER, HE DID NOT MISS A DOSE OF MEDICATION. THE PATIENT WAS STILL HAVING BREAKTHROUGH SEIZURES, INSOMNIA. THEY WERE ON KLONOPON 1MG EVERY 8 HRS AS NEEDED. AND WAS TO FOLLOWUP IN TWO WKS. PRIOR TO THIS EVENT, THEY HAD NO RECURRENCE OF SEIZURES; HE USES THE MAGNET ONCE A DAY. GOOD FAITH ATTEMPTS ARE UNDERWAY FOR FURTHER DETAILS ABOUT THE REPORTED EVENT. NO FURTHER INFORMATION HAS BEEN ATTAINED AT THIS TIME.

Description of Event or Problem · 1

NO FURTHER INFORMATION HAS BEEN ATTAINED AFTER GOOD FAITH ATTEMPTS HAVE BEEN MADE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
224009 PULSE GEN MODEL 105 PULSE GEN MODEL 105 LYJ CYBERONICS, INC. 105 3486

Patients

Seq Age Sex Outcome Treatment
1 42 YR Other