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) |