FDA Adverse Event Injury Summary report: N

CHARGING SYSTEM

MDR report key: 3134054 · Received May 23, 2013

Report

Report Number
1627487-2013-00275
Event Type
Injury
Date Received
May 23, 2013
Date of Event
May 2, 2013
Report Date
May 2, 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
AS
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS DEVICE MODEL IS ASSOCIATED WITH A FIELD CORRECTION. CORRECTIVE AND PREVENTIVE ACTION (CAPA). INVESTIGATION WAS PERFORMED. POCKET HEATING WAS CONFIRMED. THE INVESTIGATION FOR CAPA (B)(4) ASSOCIATED WITH HEATING WHILE CHARGING (POCKET HEATING) CONCLUDED THAT THE CHARGER WAS CAPABLE OF TRANSFERRING ENERGY TO THE IPG AT A RATE THAT WOULD CAUSE HEATING OF THE IPG AND/OR CHARGING WAND OF SUFFICIENT ELEVATED TEMPERATURE TO CAUSE PAIN AND BURNS. THE HEATING WHILE CHARGING WAS DETERMINED TO BE EXACERBATED BY OFF-AXIS CHARGING OF SHALLOW IMPLANTED IPGS AND THAT ALL CHARGERS WERE CAPABLE OF ELEVATED HEATING. SJM HAS LIMITED INFORMATION RELATED TO THE PATIENT'S MEDICAL HISTORY AND IS UNABLE TO FORM AN OPINION AS TO THE RELEVANCY OF THE PATIENT'S HISTORY TO THE EVENT REPORTED. SJM DEFERS TO THE PATIENT'S PHYSICIAN REGARDING MEDICAL HISTORY.

Description of Event or Problem · 1

DEVICE 2 OF 2. REF MFR REPORT: 1627487-2013-00274. IT WAS REPORTED THE PT (B)(6) EXPERIENCES HEATING AT THE IPG POCKET WHEN RECHARGING. THE REPORTED DISCOMFORT CAN BE FELT AFTER APPROX 30 MINUTES OF CHARGING. THE PT REPORTEDLY UTILIZES A BARRIER BETWEEN HER SKIN AND THE CHARGING WAND IF THE SENSATION BECOMES TOO UNCOMFORTABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
228662 CHARGING SYSTEM SCS CHARGING SYSTEM LGW ST. JUDE MEDICAL - NEUROMODULATION 3701 119907

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention IMPLANT DATE:| SCS LEADS, MODEL 3189 (2)