BEUDAMED
    FDA Adverse Event Injury Summary report: N

    OCTRODE

    MDR report key: 4093635 · Received September 4, 2014

    Report

    Report Number
    1627487-2014-06260
    Event Type
    Injury
    Date Received
    September 4, 2014
    Date of Event
    December 12, 2011
    Report Date
    August 11, 2014
    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.

    Description of Event or Problem · 1

    DEVICE 2 OF 3. REFERENCE MFR. REPORT: 1627487-2014-06259, 1627487-2014-06261. THE PATIENT HAD TWO LEADS IMPLANTED WITH THE SAME LOT NUMBER. INFORMATION PROVIDED BY THE PATIENT'S ATTORNEY, INDICATED THE PATIENT ALLEGES THE FOLLOWING ISSUES: THE PATIENT EXPERIENCED BURNING WHILE CHARGING, SHOCKING AND INCREASED RECHARGE BURDEN. PATIENT FELT THE BURNING AT HIS IPG AND LEAD SITES. THE SHOCKING OCCURRED WHILE THE DEVICE WAS ON AND WHEN PATIENT WOULD MOVE A CERTAIN WAY. THE PATIENT'S ENTIRE SCS SYSTEM WAS REMOVED (B)(6) 2011. ADDITIONAL INFORMATION IS NEEDED TO CLARIFY THE NATURE OF THE PATIENT'S ISSUES. SJM WAS MADE AWARE OF THE ISSUES ON (B)(4) 2014, AND THE PATIENT'S SCS SYSTEM WAS NOT EVALUATED BY AN SJM REPRESENTATIVE TO VERIFY AND/OR TROUBLESHOOT ANY OF THE REPORTED ISSUES PRIOR TO EXPLANT. ON 08/01/2012 ST. JUDE MEDICAL, NEUROMODULATION DIVISION, SENT FIELD ACTION LETTERS TO PATIENTS RELATED TO HEATING WHILE CHARGING AND RAISED AWARENESS OF THIS ISSUE TO PATIENTS. AN INCREASE IN PRIOR NON-REPORTED HEATING WHILE CHARGING EVENTS AND OTHER NON-REPORTED EVENTS WAS EXPECTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    542161 OCTRODE SCS LEAD GZB ST. JUDE MEDICAL - NEUROMODULATION 3186 3131303

    Patients

    Seq Age Sex Outcome Treatment
    1 37 YR Other SCS ANCHOR: MODEL 1192 (2)| IMPLANT DATE: