FDA Adverse Event
Injury
Summary report: N
EON MINI
MDR report key: 3141429
·
Received May 24, 2013
Report
- Report Number
- 1627487-2013-13803
- Event Type
- Injury
- Date Received
- May 24, 2013
- Date of Event
- March 3, 2013
- Report Date
- May 2, 2013
- Manufacturer
- ST. JUDE MEDICAL - NEUROMODULATION
- Product Code
- LGW
- PMA / PMN Number
- P010032
- Removal / Correction Number
- 1627487-12192011-003-R,
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- SC, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
A 1627487-05242011-002-R. THIS IPG SERIAL NUMBER WAS INCLUDED IN A FIELD ADVISORY. THE COMPLAINT WAS CONFIRMED: AS RECEIVED THE IPG WAS NON-RESPONSIVE. THE REPORTED COMPLAINT CANNOT BE ANALYZED AS THIS IS CONSIDERED TO BE A USER ERROR. 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
THE PT REPORTED SHE HAD NOT CHARGED HER IPG FOR OVER 3 MONTHS AND IT IS MOT LIKELY DEPLETED. FOLLOW-UP INFO IDENTIFIED THE PT'S IPG WAS EXPLANTED AND REPLACED ON (B)(6) 2013. THE PT WAS RECEIVING EFFECTIVE STIMULATION COVERAGE POSTOPERATIVE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 231984 | EON MINI | SCS IPG | LGW | ST. JUDE MEDICAL - NEUROMODULATION | 3788 | 171787 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 54 YR | Required Intervention | SCS LEAD: MODEL 3280| IMPLANTED: |