FDA Adverse Event Injury Summary report: N

SENSIA DR

MDR report key: 3861516 · Received June 10, 2014

Report

Report Number
9614453-2014-01436
Event Type
Injury
Date Received
June 10, 2014
Date of Event
April 11, 2014
Report Date
April 25, 2014
Manufacturer
IPG MFG SWITZERLAND
Product Code
NVZ
PMA / PMN Number
P980035
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

PRODUCT EVENT SUMMARY: THE DEVICE WAS RETURNED AND ANALYZED. ANALYSIS OF THE DEVICE REVEALED NORMAL BATTERY DEPLETION.

Additional Manufacturer Narrative · 1

THIS EVENT OCCURRED OUTSIDE THE US WHERE THE SAME MODEL IS DISTRIBUTED. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. PATIENT INFORMATION IS NOT GENERALLY AVAILABLE DUE TO CONFIDENTIALITY CONCERNS. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE IMPLANTABLE PULSE GENERATOR (IPG) EXHIBITED BATTERY DEPLETION WITHIN A CERTAIN NUMBER OF YEARS FROM IMPLANT AND A COMPLAINT WAS RAISED. THE IPG WAS EXPLANTED AND REPLACED. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
342691 SENSIA DR PULSE GENERATOR, PERMANENT, IMPLANTABLE NVZ IPG MFG SWITZERLAND SEDR01

Patients

Seq Age Sex Outcome Treatment
1 00072 YR Hospitalization| R