FDA Adverse Event Injury Summary report: N

EON

MDR report key: 3123501 · Received May 17, 2013

Report

Report Number
1627487-2013-01547
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 IPG SERIAL NUMBER WAS INCLUDED IN A FIELD CORRECTION. 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 4. REF MFR REPORT: 1627487-2013-1548. REF MFR REPORT: 1627487-2013-1549. 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 (B)(4) 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
219510 EON SCS IPG LGW ST. JUDE MEDICAL - NEUROMODULATION 3716 3269357

Patients

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