BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EON MINI

    MDR report key: 4112989 · Received September 17, 2014

    Report

    Report Number
    1627487-2014-25613
    Event Type
    Injury
    Date Received
    September 17, 2014
    Date of Event
    August 25, 2014
    Report Date
    August 25, 2014
    Manufacturer
    ST JUDE MED - NEUROMODULATION
    Product Code
    GZB
    PMA / PMN Number
    P010032
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GM
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    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 ((B)(6)) WAS EXPERIENCING UNCOMFORTABLE STIMULATION. X-RAYS, CT SCAN AND LEAD DIAGNOSTIC TESTING REVEALED NO ANOMALIES. REPROGRAMMING TO PROVIDE RESOLUTION WAS UNSUCCESSFUL. IN TURN, THE PT UNDERWENT SURGICAL INTERVENTION TO EXPLANT AND REPLACE THE IPG (DIFFERENT MODEL) WHICH RESOLVED THE ISSUE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    574493 EON MINI SCS IPG GZB ST JUDE MED - NEUROMODULATION 3788 3987366

    Patients

    Seq Age Sex Outcome Treatment
    1 Other SCS LEAD, MODEL: 3183| IMPLANT DATE:| IMPLANT DATE:| SCS EXTENSION, MODEL: 3383