FDA Adverse Event
Injury
Summary report: N
EON MINI
MDR report key: 3960420
·
Received July 17, 2014
Report
- Report Number
- 1627487-2014-15551
- Event Type
- Injury
- Date Received
- July 17, 2014
- Date of Event
- June 20, 2014
- Report Date
- June 26, 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
THIS IPG SERIAL NUMBER WAS INCLUDED IN A FIELD ADVISORY. SJM HAS LIMITED INFORMATION RELATED TO THE PT'S MEDICAL HISTORY AND IS UNABLE TO FORM AN OPINION AS TO THE RELEVANCY OF THE PT'S HISTORY TO THE EVENT REPORTED. SJM DEFERS TO THE PT'S PHYSICIAN REGARDING MEDICAL HISTORY.
Description of Event or Problem · 1
IT WAS REPORTED THE PT'S IPG IS REQUIRING FREQUENT CHARGING. THE PT STATED HER IPG REQUIRES CHARGING AFTER BEING IN USE FOR ONLY 4-6 HOURS. SURGICAL INTERVENTION WAS UNDERTAKEN ON (B)(6) 2014 AND THE IPG WAS EXPLANTED AND REPLACED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 420485 | EON MINI | SCS IPG | GZB | ST. JUDE MEDICAL - NEUROMODULATION | 3788 | 3290662 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 49 YR | Other | IMPLANT DATE:| SCS LEAD: MODEL 3186| SCS ANCHOR: MODEL 1192(2)| IMPLANT DATE: |