FDA Adverse Event
Injury
Summary report: N
EON MINI
MDR report key: 3950192
·
Received June 27, 2014
Report
- Report Number
- 1627487-2014-26442
- Event Type
- Injury
- Date Received
- June 27, 2014
- Date of Event
- February 19, 2014
- Report Date
- May 5, 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
THIS IPG SERIAL NUMBER WAS INCLUDED IN A FIELD ADVISORY. 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 HAS NOT CHARGED HIS SCS SYSTEM IN OVER 2-3 MONTHS HENCE, THE IPG IS UNABLE TO COMMUNICATE WITH THE PROGRAMMER OR CHARGER. THE PATIENT IS NO LONGER RECEIVING STIMULATION. FOLLOW UP INFORMATION IDENTIFIED THE PATIENT UNDERWENT A SURGICAL PROCEDURE TO REPLACE THE IPG. THE PATIENT IS NOW RECEIVING EFFECTIVE STIMULATION.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 376662 | EON MINI | SCS IPG | GZB | ST. JUDE MEDICAL -NEUROMODULATION | 3788 | 3326584 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 66 YR | Other | SCS LEAD, MODEL: 3228| IMPLANT DATE: |