FDA Adverse Event Injury Summary report: N

OCTRODE

MDR report key: 3820010 · Received May 14, 2014

Report

Report Number
1627487-2014-05343
Event Type
Injury
Date Received
May 14, 2014
Date of Event
April 22, 2014
Report Date
April 22, 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

SJM HAS LIMITED INFO RELATED TO THE PT'S MEDICAL HISTORY AND IS UNABLE TO FORM AN OPINION AS TO THE RELEVANCY OF THE PT'S HISTORY TO THE EVENT REPORTED. SJM DEFERS TO THE PT'S PHYSICIAN REGARDING MEDICAL HISTORY.

Description of Event or Problem · 1

ON (B)(6) 2014, THE PATIENT UNDERWENT A TRIAL PROCEDURE. DURING THE PROCEDURE, THE DOCTOR TOOK 45 MINUTES TO MAKE ATTEMPTS TO ACCESS THE CERVICAL AND THORACIC AREAS. THE DOCTOR WAS EVENTUALLY ABLE TO ACCESS THE THORACIC AREA BUT STRUGGLED TO DO SO. THE PATIENT EXPERIENCED PAIN ONCE THE LEAD WAS ADVANCED. AS A RESULT, THE PROCEDURE WAS ABANDONED. POST-OP, THE PATIENT WAS ASSESSED AND NO LOSS OF FUNCTION OR LONG TERM PAIN WERE PRESENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
288900 OCTRODE SCS LEAD GZB ST JUDE MEDICAL NEUROMODULATION 3086 UNK

Patients

Seq Age Sex Outcome Treatment
1 Other