FDA Adverse Event
Injury
Summary report: N
EON MINI
MDR report key: 3123527
·
Received May 17, 2013
Report
- Report Number
- 1627487-2013-13758
- Event Type
- Injury
- Date Received
- May 17, 2013
- Date of Event
- December 13, 2012
- Report Date
- April 23, 2013
- Manufacturer
- ST. JUDE MEDICAL - NEUROMODULATION
- Product Code
- LGW
- PMA / PMN Number
- P010032
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TX, 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 3. REF MFR REPORT: 1627487-2013-13759 AND 1627487-2013-13760. IT WAS REPORTED THE PT BEGAN TO EXPERIENCE PAIN AT THE IPG POCKET SITE TWO DAYS POSTOPERATIVE. THE PT REPORTED SHE HAD AN INJECTION WITH A NUMBING MEDICATION TWO DAY POSTOPERATIVE AND ANOTHER INJECTION ON (B)(6) 2013. THE PT STATED THE PT BEGINS BELOW HER IPG INCISION AND RADIATES DOWN APPROXIMATELY SIX INCHES. THE PA STATED THE PT DOES NOT HAVE AN INFECTION.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 218601 | EON MINI | SCS IPG | LGW | ST. JUDE MEDICAL - NEUROMODULATION | 3788 | 3857074 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 45 YR | Required Intervention | SCS ANCHOR: MODEL 1192 (2)| IMPLANT DATE: |