FDA Adverse Event
Injury
Summary report: N
EON MINI
MDR report key: 3182127
·
Received June 14, 2013
Report
- Report Number
- 1627487-2013-03829
- 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
- Removal / Correction Number
- 1627487-07262012-001-C
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TX, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
THIS IPG SERIAL NUMBER WAS INCLUDED IN A FIELD CORRECTION. 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: 1627487-2013-03830. THE PATIENT REPORTED SHE EXPERIENCE HEATING WHILE CHARGING AND STOPS CHARGING WHEN THE HEATING OCCURS. SUBSEQUENTLY, A LOW ENERGY REPLACEMENT CHARGING SYSTEM HAS BEEN SENT TO THE PATIENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 270897 | EON MINI | SCS IPG | LGW | ST. JUDE MEDICAL, NEUROMODULATION | 3788 | 3535789 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 42 YR | Other | SCS LEAD: MODEL 3219| IMPLANT DATE: |