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: