BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EON MINI

    MDR report key: 3123529 · Received May 17, 2013

    Report

    Report Number
    1627487-2013-01555
    Event Type
    Injury
    Date Received
    May 17, 2013
    Date of Event
    April 26, 2012
    Report Date
    April 26, 2013
    Manufacturer
    ST. JUDE MEDICAL - NEUROMODULATION
    Product Code
    LGW
    PMA / PMN Number
    P010032
    Removal / Correction Number
    1627487-07262012-002-R
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AZ, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    THIS IPG SERIAL NUMBER WAS INCLUDED IN A FIELD ADVISORY. SJM HAS LIMITED INFORMATION 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 2. REFERENCE MFR REPORT: 1627487-2013-1554. IT WAS REPORTED THE PT IS NOT RECEIVING EFFECTIVE STIMULATION. THE PT STOPPED USING AND CHARGING HER SCS SYSTEM OVER A YEAR AGO DUE TO INEFFECTIVE STIMULATION. THE PT'S SON REPORTED THE PT WAS REPROGRAMMED MULTIPLE TIMES BUT EFFECTIVE STIMULATION WAS NOT ACHIEVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    218889 EON MINI SCS IPG LGW ST. JUDE MEDICAL - NEUROMODULATION 3788 3175236

    Patients

    Seq Age Sex Outcome Treatment
    1 83 YR Required Intervention