FDA Adverse Event Injury Summary report: N

EON MINI

MDR report key: 3890466 · Received June 4, 2014

Report

Report Number
1627487-2014-01387
Event Type
Injury
Date Received
June 4, 2014
Date of Event
May 15, 2014
Report Date
May 15, 2014
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION
Product Code
GZB
PMA / PMN Number
P010032
Removal / Correction Number
1627487-07262012-002-R
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

CORRECTION NUMBER: 1627487-12192011-003-R. THIS IPG SERIAL NUMBER WAS INCLUDED IN A FIELD ADVISORIES. 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 PT EXPERIENCES AN OCCASIONAL SHOCKING/STINGING SENSATION AT THE IPG SITE WHEN STIMULATION IS ON, HOWEVER, IT'S NOT RELATED TO RECHARGING. FOLLOW-UP IDENTIFIED STIMULATION IS WORKING PROPERLY. SURGICAL INTERVENTION MAY BE UNDERTAKEN AS THE NEXT COURSE OF ACTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
327418 EON MINI SCS IPG GZB ST. JUDE MEDICAL - NEUROMODULATION 3788 2788115

Patients

Seq Age Sex Outcome Treatment
1 67 YR Other IMPLANT DATE:| SCS LEAD, MODEL 3225| IMPLANT DATE:| SCS LEAD, MODEL 3189