FDA Adverse Event Injury Summary report: N

IMPLANTABLE NEUROSTIMULATOR

MDR report key: 3160179 · Received June 10, 2013

Report

Report Number
3007566237-2013-01916
Event Type
Injury
Date Received
June 10, 2013
Report Date
May 20, 2013
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P840001
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PRODUCT ID: NEU_UNKNOWN_LEAD, PRODUCT TYPE: LEAD. (B)(4).

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT¿S DEVICE LASTED ¿ONLY 18 MONTHS.¿ IT WAS INDICATED THAT THE DEVICE WAS REPLACED. IT WAS NOTED THAT THE PATIENT WAS (B)(6) AND OTHER THAN PAIN MANAGEMENT, SHE WAS FINE BUT THE REPORTER STATED THAT THE SURGERIES FOR ¿SHORT-LIVED BATTERIES¿ THREATENED HER LIFE AT HER AGE. ADDITIONAL INFORMATION HAS BEEN REQUESTED BUT WAS NOT AVAILABLE AS OF THE DATE OF THIS REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
260385 IMPLANTABLE NEUROSTIMULATOR STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW MEDTRONIC NEUROMODULATION

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention