FDA Adverse Event Injury Summary report: N

EON

MDR report key: 4163257 · Received October 8, 2014

Report

Report Number
1627487-2014-03649
Event Type
Injury
Date Received
October 8, 2014
Date of Event
August 26, 2014
Report Date
September 19, 2014
Manufacturer
ST. JUDE MEDICAL - NEUROMODULATION
Product Code
GZB
PMA / PMN Number
P010032
Removal / Correction Number
1627487-07262012-001-C
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS IPG SERIAL NUMBER WAS INCLUDED IN A FIELD CORRECTION. SJM HAS LIMITED INFO 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 1 OF 2. REFERENCE MFR REPORT# : 1627487-2014-03650. THE PATIENT'S SPOUSE REPORTED THE PATIENT EXPERIENCED HEATING AT THE SCS IPG POCKET SITE WHILE CHARGING. AS A RESULT, THE PATIENT HAS NOT CHARGED IN 3 TO 4 WEEKS. A REPLACEMENT MODEL 3726 CHARGING SYSTEM HAS BEEN SENT TO THE PATIENT. ON 08/01/2012 ST. JUDE MEDICAL, NEUROMODULATION DIV, 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
633652 EON SCS IPG GZB ST. JUDE MEDICAL - NEUROMODULATION 3716 117681

Patients

Seq Age Sex Outcome Treatment
1 67 YR Other IMPLANT DATE:| SCS LEAD, MODEL: 3186 (2)