FDA Adverse Event Injury Summary report: N

EON MINI

MDR report key: 3954943 · Received July 16, 2014

Report

Report Number
1627487-2014-05502
Event Type
Injury
Date Received
July 16, 2014
Report Date
August 5, 2016
Manufacturer
ST JUDE MEDICAL NEUROMODULATION
Product Code
GZB
PMA / PMN Number
P010032
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

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.

Additional Manufacturer Narrative · 1

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

DEVICE 3 OF 3. REFER TO MFR REPORTS 1627487-2013-05268, 1627487-2013-05269.

Description of Event or Problem · 1

DEVICE 3 OF 3: REFERENCE MFR. REPORT#: 1627487-2013-05268, REFERENCE MFR. REPORT#: 1627487-2013-05269.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
416032 EON MINI SCS IPG GZB ST JUDE MEDICAL NEUROMODULATION 3788 3895944

Patients

Seq Age Sex Outcome Treatment
1 Other