BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EON MINI

    MDR report key: 4143049 · Received September 23, 2014

    Report

    Report Number
    1627487-2014-12644
    Event Type
    Injury
    Date Received
    September 23, 2014
    Date of Event
    August 21, 2014
    Report Date
    September 2, 2014
    Manufacturer
    ST. JUDE MEDICAL - NEUROMODULATION
    Product Code
    GZB
    PMA / PMN Number
    P010032
    Removal / Correction Number
    1627487-12192011-003-R
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    THE SERIAL NUMBER WAS INCLUDED IN FIELD ADVISORIES. 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 THE PT HAS NOT USED HIS SYSTEM IN APPROXIMATELY A YEAR. THE CHARGER GIVES AN ERROR WHEN THE PT ATTEMPTS TO CHARGE THE IPG. A NEW CHARGER WAS USED WITH THE SAME RESULT. THE PT WILL CONSULT WITH THE SURGEON TO HAVE THE IPG REPLACED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    591183 EON MINI SCS IPG GZB ST. JUDE MEDICAL - NEUROMODULATION 3788 3079788

    Patients

    Seq Age Sex Outcome Treatment
    1 61 YR Other IMPLANT DATE:| SCS LEAD, MODEL: 3214