FDA Adverse Event
Injury
Summary report: N
EON MINI
MDR report key: 3231532
·
Received July 12, 2013
Report
- Report Number
- 1627487-2013-06604
- Event Type
- Injury
- Date Received
- July 12, 2013
- Date of Event
- June 17, 2013
- Report Date
- June 17, 2013
- Manufacturer
- ST JUDE MEDICAL - NEUROMODULATION
- Product Code
- LGW
- PMA / PMN Number
- P010032
- Removal / Correction Number
- 1627487-12192011-003-R
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TX, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
CORRECTION NUMBER: 1627487-05242011-002-R AND 1627487-07262012-002-R. THIS IPG SERIAL NUMBER WAS INCLUDED IN FIELD ADVISORIES. SJM HAS LIMITED INFO 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 PT IS GOING TO HAVE HIS IPG REPLACED. THE PT STATED HE HAS ELECTIVELY DECIDED TO REPLACE HIS IPG WITH A NEWER IPG (SAME MODEL) TO FURTHER REDUCE HIS RECHARGE INTERVALS. THERE IS NO ALLEGED DEFICIENCY WITH THE DEVICE. SURGICAL INTERVENTION WILL BE UNDERTAKEN AT A LATER DATE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 322067 | EON MINI | SCS IPG | LGW | ST JUDE MEDICAL - NEUROMODULATION | 3788 | 173930 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 70 YR | Other | IMPLANT DATE:| SCS LEAD: MODEL 3214 |