FDA Adverse Event
Malfunction
Summary report: N
EON PATIENT PROGRAMMER
MDR report key: 3123946
·
Received May 17, 2013
Report
- Report Number
- 1627487-2013-01545
- Event Type
- Malfunction
- Date Received
- May 17, 2013
- Date of Event
- April 23, 2013
- Report Date
- April 23, 2013
- Manufacturer
- ST. JUDE MEDICAL - NEUROMODULATION
- Product Code
- LGW
- PMA / PMN Number
- P010032
- Product Problem
- 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
IT WAS REPORTED THE PT'S BUTTONS ON THE SCS PROGRAMMER ARE STICKING. A REPLACEMENT SCS PROGRAMMER WAS SENT TO THE PT TO RESOLVE THE ISSUE. FOLLOW UP INFO IDENTIFIED THE ISSUE IS RESOLVED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 219060 | EON PATIENT PROGRAMMER | SCS PROGRAMMER | LGW | ST. JUDE MEDICAL - NEUROMODULATION | 3851 | 40316 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 54 YR | Required Intervention | IMPLANTED:| SCS IPG: MODEL 3716| IMPLANTED:| SCS LEAD: MODEL 3245 |