FDA Adverse Event Injury Summary report: N

LAMITRODE S8

MDR report key: 3960995 · Received July 22, 2014

Report

Report Number
1627487-2014-24042
Event Type
Injury
Date Received
July 22, 2014
Date of Event
June 13, 2014
Report Date
June 30, 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

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 1 OF 2. REFERENCE MFR REPORT: 1627487-2014-24043. IT WAS REPORTED DURING THE POST-OPERATIVE APPOINTMENT FOLLOWING THE PATIENT'S PERMANENT IMPLANT, PROGRAMMING WAS UNSUCCESSFUL AS STIMULATION COULD NOT COVER THE ENTIRE PAIN PATTERN. FOLLOW-UP IDENTIFIED A SECOND REPROGRAMMING ATTEMPT WAS UNSUCCESSFUL AS UNINTENDED RIB STIMULATION AND INCOMPLETE COVERAGE OCCURRED. IT WAS ALSO REPORTED REPROGRAMMING COULD NOT BE COMPLETED DUE TO THE PATIENT EXPERIENCING HEAD PRESSURE. THE NEXT COURSE OF ACTION IS UNDETERMINED AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
429188 LAMITRODE S8 SCS LEAD GZB ST. JUDE MEDICAL - NEUROMODULATION 3286 3885819

Patients

Seq Age Sex Outcome Treatment
1 54 YR Other SCS ANCHOR: MODEL 1192 (2)| SCS IPG: MODEL 3789| IMPLANT DATE:| IMPLANT DATE: