FDA Adverse Event Injury Summary report: N

LAMITRODE S8

MDR report key: 3161449 · Received June 5, 2013

Report

Report Number
1627487-2013-15767
Event Type
Injury
Date Received
June 5, 2013
Date of Event
April 24, 2013
Report Date
May 15, 2013
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P010032
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

SJM HAS LIMITED INFORMATION RELATED TO THE PATIENT'S MEDICAL HISTORY AND IS UNABLE TO FORM AN OPINION AS TO THE RELEVANCY OF THE PATIENT'S HISTORY TO THE EVENT REPORTED. SJM DEFERS TO THE PATIENT'S PHYSICIAN REGARDING MEDICAL HISTORY.

Description of Event or Problem · 1

DEVICE 1 OF 2. REFERENCE MFR REPORT: 1627487-2013-15768. IT WAS REPORTED THE PATIENT WAS EXPERIENCING LEG WEAKNESS. THE PHYSICIAN ELECTED TO EXPLANT THE PATIENT'S SCS SYSTEM ON (B)(6) 2013, IN CASE THE WEAKNESS WAS CAUSED BY CORD COMPRESSION. NO ADDITIONAL INFORMATION IS AVAILABLE AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
248703 LAMITRODE S8 SCS LEAD LGW ST. JUDE MEDICAL - NEUROMODULATION 3286 3593583

Patients

Seq Age Sex Outcome Treatment
1 60 YR Required Intervention IMPLANT DATE:| IMPLANT DATE:| SCS IPG: MODEL 3788| SCS ANCHOR, MODEL 1192 (2)