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: