BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EON MINI

    MDR report key: 3810616 · Received May 6, 2014

    Report

    Report Number
    1627487-2014-23293
    Event Type
    Injury
    Date Received
    May 6, 2014
    Date of Event
    April 14, 2014
    Report Date
    April 14, 2014
    Manufacturer
    ST. JUDE MEDICAL, NEUROMODULATION
    Product Code
    GZB
    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 INVOLVED 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 PATIENT IS UNABLE TO CHARGE HIS IPG. AS A RESULT, THE PATIENT IS WITHOUT STIMULATION. SUBSEQUENTLY, THE SJM REPRESENTATIVE MET WITH THE PATIENT AND CONFIRMED THE PATIENT'S IPG IS INOPERABLE. THE PATIENT WILL UNDERGO SURGICAL INTERVENTION AT A FUTURE DATE TO ADDRESS THE ISSUE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    271757 EON MINI SCS IPG GZB ST. JUDE MEDICAL, NEUROMODULATION 3788 3161654

    Patients

    Seq Age Sex Outcome Treatment
    1 54 YR Other IMPLANT DATE:| SCS ANCHOR, MODEL 1192 (2)| SCS LEAD, MODEL 3186 (2)| IMPLANT DATE: