FDA Adverse Event
Injury
Summary report: N
EON MINI
MDR report key: 4223273
·
Received October 29, 2014
Report
- Report Number
- 1627487-2014-20385
- Event Type
- Injury
- Date Received
- October 29, 2014
- Date of Event
- July 9, 2014
- Report Date
- October 9, 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
CORRECTION NUMBERS: 1627487-07262012-002-R, 1627487-05242011-002-R. THIS IPG SERIAL NUMBER WAS INCLUDED IN FIELD ADVISORIES. 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. UDI(DI): (B)(4).
Description of Event or Problem · 1
IT WAS REPORTED THE PATIENT'S IPG BECAME INOPERABLE DUE TO NOT CHARGING IT FOR ABOUT 3 MONTHS. THE SJM REP CONFIRMED THE COMMUNICATION ISSUE BETWEEN IPG AND MULTIPLE EXTERNAL DEVICES. SURGICAL INTERVENTION WILL BE TAKEN AT A LATER TO ADDRESS THE ISSUE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 691132 | EON MINI | SCS IPG | GZB | ST. JUDE MEDICAL - NEUROMODULATION | 3788 | 3166349 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 49 YR | Other | IMPLANT DATE:| SCS LEAD, MODEL: 3228, |