FDA Adverse Event
Injury
Summary report: N
EON MINI
MDR report key: 3192040
·
Received June 20, 2013
Report
- Report Number
- 1627487-2013-08231
- Event Type
- Injury
- Date Received
- June 20, 2013
- Date of Event
- May 28, 2013
- Report Date
- May 28, 2013
- Manufacturer
- ST. JUDE MEDICAL - NEUROMODULATION
- Product Code
- LGW
- PMA / PMN Number
- P010032
- Removal / Correction Number
- 1627487-07262012-002-R
- 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 ADVISORY. 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'S PHYSICIAN IMPLANTED A NEW IPG (IMPLANTABLE PULSE GENERATOR) AND CONNECTED THE EXISTING THORACIC LEAD FROM THE EXISTING IPG TO THE NEW IPG. THE ORIGINAL IPG REMAINED IMPLANTED. FOLLOW-UP INFORMATION RECEIVED THE REASON FOR THE ADDITION OF THE IPG AS INCREASED RECHARGE BURDEN. IT WAS REPORTED THE PATIENT HAD EFFECTIVE STIMULATION AND WAS RECHARGING EVERY FOUR DAYS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 281025 | EON MINI | SCS IPG | LGW | ST. JUDE MEDICAL - NEUROMODULATION | 3788 | 3359052 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 55 YR | Other | SCS LEAD, MODEL 3186| SCS EXTENSION, MODEL 3383| IMPLANT DATE:| IMPLANT DATE:| SCS ANCHOR, MODEL 1192| SCS LEAD, MODEL 3189| IMPLANT DATE:| IMPLANT DATE: |