BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EON MINI

    MDR report key: 3182082 · Received June 14, 2013

    Report

    Report Number
    1627487-2013-03826
    Event Type
    Injury
    Date Received
    June 14, 2013
    Date of Event
    May 21, 2013
    Report Date
    May 21, 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

    IT WAS REPORTED, THE PATIENT EXPERIENCED PAIN AT HER SCS IPG POCKET SITE. SUBSEQUENTLY, THE SCS IPG WAS RELOCATED TO THE PATIENT'S ABDOMEN. FOLLOW-UP IDENTIFIED THE PATIENT IS EXPERIENCING POST OPERATIVE PAIN. NO ADDITIONAL INFORMATION IS AVAILABLE AT THIS TIME.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    270961 EON MINI SCS IPG LGW ST. JUDE MEDICAL, NEUROMODULATION 3788 3610098

    Patients

    Seq Age Sex Outcome Treatment
    1 77 YR Other SCS LEAD: MODEL 3219| IMPLANT DATE: