FDA Adverse Event Injury Summary report: N

EON MINI

MDR report key: 3926233 · Received June 2, 2014

Report

Report Number
1627487-2014-01375
Event Type
Injury
Date Received
June 2, 2014
Date of Event
January 9, 2014
Report Date
May 9, 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

RECALL: 1627487-12192011-003-R. THIS IPG SERIAL NUMBER WAS INCLUDED IN 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 IPG IS INOPERABLE AND WILL NOT COMMUNICATE WITH ANY EXTERNAL DEVICES. FOLLOW-UP IDENTIFIED THE PATIENT FAILED TO RECHARGE THE DEVICE FOR APPROXIMATELY 5 MONTHS. AS A RESULT, HE HAS BEEN WITHOUT STIMULATION SINCE (B)(6) 2014. SURGICAL INTERVENTION WAS UNDERTAKEN ON (B)(6) 2014. THE IPG WA EXPLANTED AND REPLACED. EFFECTIVE STIMULATION WAS ACHIEVED POSTOPERATIVELY. THE ISSUE IS RESOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
322168 EON MINI SCS IPG GZB ST. JUDE MEDICAL ¿ NEUROMODULATION 3788 2897066

Patients

Seq Age Sex Outcome Treatment
1 58 YR Other IMPLANT DATE:| SCS LEAD, MODEL 3186