FDA Adverse Event
Injury
Summary report: N
EON MINI
MDR report key: 3223015
·
Received July 10, 2013
Report
- Report Number
- 1627487-2013-04866
- Event Type
- Injury
- Date Received
- July 10, 2013
- Date of Event
- May 19, 2013
- Report Date
- June 18, 2013
- Manufacturer
- ST. JUDE MEDICAL - NEUROMODULATION
- Product Code
- LGW
- PMA / PMN Number
- P010032
- Removal / Correction Number
- 1627487-05242011-002-R
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NJ, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
CORRECTION NUMBER: 1627487-07262012-002-R. THIS IPG SERIAL NUMBER WAS INCLUDED IN FIELD ADVISORIES. 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 HAD AN INCREASED RECHARGE BURDEN WITH THE IPG. THE PHYSICIAN PLANNED TO UNDERTAKE SURGICAL INTERVENTION TO REPLACE THE IPG. IT WAS REPORTED THE PATIENT HAD TO RECHARGE THE IPG DAILY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 317674 | EON MINI | SCS IPG | LGW | ST. JUDE MEDICAL - NEUROMODULATION | 3788 | 2897067 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 63 YR | IMPLANT:| SCS LEAD: MODEL 3219 |