FDA Adverse Event Injury Summary report: N

EON MINI

MDR report key: 4143079 · Received September 23, 2014

Report

Report Number
1627487-2014-12640
Event Type
Injury
Date Received
September 23, 2014
Date of Event
August 28, 2014
Report Date
August 30, 2014
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION
Product Code
GZB
PMA / PMN Number
P010032
Removal / Correction Number
1627487-07262012-002-R
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

RECALL: THIS IPG SERIAL NUMBER WAS INCLUDED IN A FIELD ADVISORY. 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'S IPG REQUIRED EXCESSIVE CHARGING. A REPLACEMENT CHARGER DID NOT RESOLVE THE ISSUE. THE IPG WAS EXPLANTED AND REPLACED. THE PT'S ISSUE WAS RESOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
591190 EON MINI SCS IPG GZB ST. JUDE MEDICAL - NEUROMODULATION 3788 3389156

Patients

Seq Age Sex Outcome Treatment
1 70 YR Other IMPLANT DATE:| SCS ANCHORS, MODEL: 1192| SCS LEADS, MODEL: 3186| IMPLANT DATE: