FDA Adverse Event Injury Summary report: N

EON MINI

MDR report key: 3820901 · Received May 13, 2014

Report

Report Number
1627487-2014-12353
Event Type
Injury
Date Received
May 13, 2014
Date of Event
April 18, 2014
Report Date
April 22, 2014
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION
Product Code
LGW
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 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 EXPERIENCES BURNING AND DISCOMFORT AT THE IPG SITE. SURGICAL INTERVENTION IS PLANNED TO ADDRESS THE ISSUE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
287511 EON MINI SCS IPG LGW ST. JUDE MEDICAL - NEUROMODULATION 3788 4252499

Patients

Seq Age Sex Outcome Treatment
1 58 YR Other SCS IPG: MODEL 3228| IMPLANT DATE: