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: |