FDA Adverse Event Injury Summary report: N

CHARGING SYSTEM

MDR report key: 4091993 · Received August 27, 2014

Report

Report Number
1627487-2014-06256
Event Type
Injury
Date Received
August 27, 2014
Date of Event
January 11, 2011
Report Date
August 4, 2014
Manufacturer
ST. JUDE MEDICAL, NEUROMODULATION
Product Code
GZB
PMA / PMN Number
P010032
Removal / Correction Number
1627487-07262012-001-C
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS CHARGER MODEL WAS ASSOCIATED WITH A FIELD CORRECTION. MANUFACTURER'S EVALUATION: CORRECTIVE AND PREVENTIVE ACTION (CAPA) INVESTIGATION WAS PERFORMED. RESULT : POCKET HEATING WAS CONFIRMED. THE INVESTIGATION FOR CAPA (B)(4) ASSOCIATED WITH HEATING WHILE CHARGING (POCKET HEATING) CONCLUDED THAT THE CHARGER WAS CAPABLE OF TRANSFERRING ENERGY TO THE IPG AT A RATE THAT WOULD CAUSE HEATING OF THE IPG AND/OR CHARGING WAND OF SUFFICIENT ELEVATED TEMPERATURE TO CAUSE PAIN AND BURNS. THE HEATING WHILE CHARGING WAS DETERMINED TO BE EXACERBATED BY OFF-AXIS CHARGING OF SHALLOW IMPLANTED IPGS AND THAT ALL CHARGERS WERE CAPABLE OF ELEVATED HEATING. SJM HAS LIMITED INFO 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 4 OF 4. REFERENCE MFR REPORT: 1627487-2014-06253. REFERENCE MFR REPORT: 1627487-2014-06254. REFERENCE MFR REPORT: 1627487-2014-06255.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
518638 CHARGING SYSTEM SCS CHARGING SYSTEM GZB ST. JUDE MEDICAL, NEUROMODULATION 3701 48561

Patients

Seq Age Sex Outcome Treatment
1 54 YR Other