FDA Adverse Event Injury Summary report: N

EON MINI

MDR report key: 3141323 · Received May 24, 2013

Report

Report Number
1627487-2013-01571
Event Type
Injury
Date Received
May 24, 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
1627487-07262012-002-R
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS IPG SERIAL NUMBER WAS INCLUDED IN A FIELD ADVISORY. 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 PATIENT IS NOT RECEIVING STIMULATION AND IS UNABLE TO COMMUNICATE WITH OR CHARGE HIS IPG. THE PATIENT STATED HE HAS NOT USED OR CHARGED HIS IPG FOR TWO YEARS. THE PATIENT'S PAIN HAS RETURNED AND HE WOULD LIKE TO USE HIS SCS SYSTEM AGAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
231637 EON MINI SCS IPG LGW ST. JUDE MEDICAL NEUROMODULATION 3788 3395365

Patients

Seq Age Sex Outcome Treatment
1 83 YR Required Intervention SCS LEAD: MODEL 3228| IMPLANT DATE: