FDA Adverse Event Injury Summary report: N

CHARGING SYSTEM

MDR report key: 4240516 · Received October 30, 2014

Report

Report Number
1627487-2014-26917
Event Type
Injury
Date Received
October 30, 2014
Date of Event
February 10, 2014
Report Date
October 10, 2014
Manufacturer
ST. JUDE MED - 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 WITH A FIELD CORRECTION. MANUFACTURER'S EVALUATION: CORRECTIVE AND PREVENTIVE ACTION (CAPA) INVESTIGATION WAS PERFORMED. SECTION: EVALUATION CODES: RESULT: POCKET HEATING WAS 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 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 #2 OF 2: REFERENCE MFR. REPORT: 1627487-2014-26916. IT WAS REPORTED THE IPG WAS UNABLE TO COMMUNICATE WITH CHARGER FOR THE PAST MONTH. IN ADDITION, THE PATIENT REPORTS SHE EXPERIENCED POCKET HEATING WHILE RECHARGING FOR THE PAST 7-8 MONTHS AS WELL AS THE CHARGER PADDLE BECOMING WARM. THE PATIENT REPORTS SHE WOULD TAKE A BREAK FROM CHARGING ONCE THE HEATING BECAME UNCOMFORTABLE. A REPLACEMENT MODEL 3726 CHARGING SYSTEM WAS SENT TO THE PATIENT WHICH RESOLVED THE ISSUES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
697089 CHARGING SYSTEM SCS CHARGING SYSTEM GZB ST. JUDE MED - NEUROMODULATION 3711 4080687

Patients

Seq Age Sex Outcome Treatment
1 34 YR Other IMPLANT DATE:| SCS EXTENSION: MODEL 3346| IMPLANT DATE:| PNS LEAD: MODEL 3166(2)| PNS LEAD: MODEL 3169| IMPLANT DATE:| SCS EXTENSION: MODEL 3343| IMPLANT DATE: