FDA Adverse Event Injury Summary report: N

CHARGING SYSTEM

MDR report key: 3123499 · Received May 17, 2013

Report

Report Number
1627487-2013-01549
Event Type
Injury
Date Received
May 17, 2013
Date of Event
April 25, 2013
Report Date
April 25, 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
VA, 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 PERFORMED. RESULT: 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 TEMP 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 CHARGERS WERE CAPABLE OF ELEVATED HEATING. 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 3 OF 4. REF MFR REPORT: 1627487-2013-1547. REF MFR REPORT: 1627487-2013-1548. REF MFR REPORT: 1627487-2013-1550. IT WAS REPORTED THE PT IS EXPERIENCING A HEATING SENSATION AT HIS IPG SITE WHILE CHARGING. THE PT HAS TWO SCS SYSTEMS. TWO REPLACEMENT CHARGERS WERE SENT TO THE PT TO ADDRESS THE ISSUE. ON 08/01/2012 ST JUDE MEDICAL, NEUROMODULATION DIV., SENT FIELD ACTION LETTERS TO PTS RELATED TO HEATING WHILE CHARGING AND RAISED AWARENESS OF THIS ISSUE TO PTS. AN INCREASE IN PRIOR NON-REPORTED HEATING WHILE CHARGING EVENTS AND OTHER NON-REPORTED EVENTS ARE EXPECTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
219215 CHARGING SYSTEM SCS CHARGER LGW ST. JUDE MEDICAL - NEUROMODULATION 3711 3364554

Patients

Seq Age Sex Outcome Treatment
1 42 YR Required Intervention IMPLANT DATE:| IMPLANT DATE:| SCS LEAD: MODEL 3166 (2)| IMPLANT DATE:| SCS LEAD: MODEL 3149 (2)| IMPLANT DATE:| SCS EXTENSION: MODEL 3346 (2)| SCS EXTENSION: MODEL 3346 (2)