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 |