FDA Adverse Event Injury Summary report: N

EON MINI

MDR report key: 3810612 · Received May 6, 2014

Report

Report Number
1627487-2014-12331
Event Type
Injury
Date Received
May 6, 2014
Date of Event
April 15, 2014
Report Date
April 15, 2014
Manufacturer
ST. JUDE MEDICAL, NEUROMODULATION
Product Code
GZB
PMA / PMN Number
P010032
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

METHOD: THE DEVICE HISTORY AND STERILIZATION RECORDS WERE REVIEWED. RESULTS: THE DEVICE HISTORY AND STERILIZATION RECORDS REVIEWED WERE FOUND TO MEET SPECIFICATIONS AND NO ANOMALIES RELATED TO THIS EVENT WERE FOUND. CONCLUSION: THE CAUSE OF THE REPORTED COMPLAINT COULD NOT BE DETERMINED FROM THE REVIEW OF THE DHR AND STERILIZATION RECORDS. 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

DEVICE 1 OF 4. REFERENCE MFR REPORT #1627487-2014-12332, REFERENCE MFR REPORT #1627487-2014-12333, AND REFERENCE MFR REPORT #1627487-2014-12334. IT WAS REPORTED THE PATIENT REPORTED A FEVER AND FEELING SICK. SHE ALSO REPORTED PAIN AT THE IMPLANT SITE. IT IS UNKNOWN WHICH IMPLANT SITE WAS CAUSING THE PAIN. THE PHYSICIAN PRESCRIBED ANTIBIOTICS. F/U REVEALED THE PATIENT IS FEELING BETTER AND THE PAIN AT THE IMPLANT SITE IS IMPROVING. THE PATIENT WILL CONTINUE HER COURSE OF ANTIBIOTICS AND F/U WITH HER PHYSICIAN. NOTE THE PATIENT HAS 2 ANCHORS FROM THE SAME LOT NUMBER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
271390 EON MINI SCS IPG GZB ST. JUDE MEDICAL, NEUROMODULATION 3788 4438940

Patients

Seq Age Sex Outcome Treatment
1 46 YR Other