FDA Adverse Event Injury Summary report: N

EON MINI

MDR report key: 3960633 · Received July 21, 2014

Report

Report Number
1627487-2014-26578
Event Type
Injury
Date Received
July 21, 2014
Date of Event
June 29, 2014
Report Date
June 29, 2014
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION
Product Code
GZB
PMA / PMN Number
P010032
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

EVALUATION: METHOD - THE DEVICE HISTORY AND STERILIZATION RECORDS WERE REVIEWED. RESULTS - THE DEVICE HISTORY AND STERILIZATION RECORDS REVIEWED WERE FOUND TO MEET SPECIFICATIONS AND NO ANOMALIES RELATED TO THIS EVENT WERE FOUND. CONCLUSION - THE CAUSE OF THE REPORTED COMPLAINT COULD NOT BE DETERMINED FROM THE REVIEW OF THE DHR AND STERILIZATION RECORDS." 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, AT THE PATIENT'S IPG INCISION SITE LOCATED IN HIS RIGHT FLANK THERE WAS A LESION IN THE CENTER THAT WOULD NOT HEAL AND WAS DRAINING. CULTURES WERE TAKEN AND THE RESULTS WERE NEGATIVE FOR INFECTION, HOWEVER; THE PATIENT WAS ON AN EXTENDED COURSE OF ANTIBIOTICS PRIOR TO THE CULTURES. THE PATIENT UNDERWENT A SURGICAL PROCEDURE ON (B)(6) 2014 WHERE THE IPG SITE WAS OPENED AND THE WOUND CLEANED AND THERE WAS EXTENSIVE AMOUNT OF COLORED DRAINAGE PRESENT. THE IPG POCKET WAS WASHED AND THE IPG WAS SOAKED IN BETADINE AND ANTIBIOTIC POWDER WAS POURED INTO THE IPG SITE PRIOR TO THE WOUND BEING CLOSED. FURTHER FOLLOW UP IS PENDING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
426651 EON MINI SCS IPG GZB ST. JUDE MEDICAL - NEUROMODULATION 3788 4562679

Patients

Seq Age Sex Outcome Treatment
1 38 YR Other SCS LEAD: MODEL 3228| IMPLANT: