FDA Adverse Event Injury Summary report: N

EON MINI

MDR report key: 3141706 · Received May 24, 2013

Report

Report Number
1627487-2013-04646
Event Type
Injury
Date Received
May 24, 2013
Date of Event
February 4, 2013
Report Date
May 2, 2013
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P010032
Adverse Event
Yes
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 WAS UNABLE TO RECHARGE THE IPG, AND A REPLACEMENT CHARGING SYSTEM DID NOT RESOLVE THE ISSUE. IT WAS REPORTED THE IPG MAY BE TILTED, WHICH COULD BE CAUSING DIFFICULTY COMMUNICATING BETWEEN THE CHARGING SYSTEM AND THE IPG. IT WAS REPORTED THE PHYSICIAN MAY UNDERTAKE SURGICAL INTERVENTION TO ADDRESS THE ISSUE AT A FUTURE DATE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
230652 EON MINI SCS IPG LGW ST. JUDE MEDICAL - NEUROMODULATION 3788 3845084

Patients

Seq Age Sex Outcome Treatment
1 28 YR Required Intervention IMPLANTED:| SCS LEAD: MODEL 3186 (2)| IMPLANTED:| SCS ANCHOR: MODEL 1192 (2)