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