FDA Adverse Event
Injury
Summary report: N
EON MINI
MDR report key: 4143226
·
Received September 22, 2014
Report
- Report Number
- 1627487-2014-23620
- Event Type
- Injury
- Date Received
- September 22, 2014
- Date of Event
- June 27, 2014
- Report Date
- August 28, 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
IT WAS REPORTED THE PATIENT HAS NOT USED OR CHARGED HIS IPG IN APPROXIMATELY 2 MONTHS. SUBSEQUENTLY, THE PATIENT'S IPG BECAME INOPERABLE. THE SJM REPRESENTATIVE MET WITH THE PATIENT AND WAS UNABLE TO ESTABLISH COMMUNICATION BETWEEN THE PATIENT'S IPG AND EXTERNAL DEVICES. SURGICAL INTERVENTION MAY BE PENDING TO ADDRESS THE REPORTED ISSUE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 587649 | EON MINI | SCS IPG | GZB | ST. JUDE MEDICAL - NEUROMODULATION | 3788 | 3734243 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 65 YR | Other | SCS ANCHOR: MODEL 1194 (2)| IMPLANT:| IMPLANT:| SCS LEAD: MODEL 3186 (2) |