FDA Adverse Event Injury Summary report: N

CHARGING SYSTEM

MDR report key: 4181362 · Received September 17, 2014

Report

Report Number
1627487-2014-24202
Event Type
Injury
Date Received
September 17, 2014
Date of Event
August 28, 2014
Report Date
August 28, 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
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS CHARGER MODEL WAS ASSOCIATED IN A FIELD CORRECTION. CORRECTIVE AND PREVENTIVE ACTION CAPA) INVESTIGATION WAS PERFORMED. RESULT - POCKET HEATING CONFIRMED. THE INVESTIGATION FOR CAPA (B)(4) ASSOCIATED WITH HEATING WHILE CHARGING (POCKET HEATING) CONCLUDED THAT THE CHARGER WAS CAPABLE OF TRANSFERRING ENERGY TO THE IPG AT A RATE THAT WOULD CAUSE HEATING OF THE IPG AND/OR CHARGING WAND OF SUFFICIENT ELEVATED TEMPERATURE TO CAUSE PAIN AND BURNS. THE HEATING WHILE CHARGING WAS DETERMINED TO BE EXACERBATED BY OFF-AXIS CHARGING OF SHALLOW IMPLANTED IPGS AND THAT ALL CHARGERS WERE CAPABLE OF ELEVATED HEATING. 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

DEVICE 2 OF 2. REFERENCE MFR REPORT: 1627487-2014-24201.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
573873 CHARGING SYSTEM SCS CHARGING SYSTEM GZB ST. JUDE MEDICAL - NEUROMODULATION 3711 3800973

Patients

Seq Age Sex Outcome Treatment
1 43 YR Other SCS LEAD: MODEL 3214| IMPLANT DATE: