FDA Adverse Event Injury Summary report: N

NCP PULSE GENERATOR

MDR report key: 429453 · Received November 21, 2002

Report

Report Number
1644487-2002-00503
Event Type
Injury
Date Received
November 21, 2002
Date of Event
October 24, 2002
Report Date
November 6, 2002
Manufacturer
CYBERONICS, INC.
Product Code
LYJ
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
DC, US
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

PATIENT'S NCP SYSTEM WAS EXPLANTED DUE TO LACK OF EFFICACY AND INFECTION. THE DEVICE WAS PROGRAMMED TO OFF IN 2002, DUE TO LACK OF EFFICACY. THE INFECTION WAS FIRST NOTED 8 MO LATER AT THE BIPOLAR LEAD/CERVICAL AREA, AND WAS TREATED WITH ANTIBIOTICS AND EXPLANT OF NCP SYSTEM. THE INFECTION IS RESOLVED AND RE-IMPLANT IS NOT SCHEDULED AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NCP PULSE GENERATOR PULSE GENERATOR LYJ CYBERONICS, INC. 101 4398

Patients

Seq Age Sex Outcome Treatment
1 10 YR Hospitalization| R EXPIR DATE 01/31/2003, DATE OF MFG 01/30/2001,| STERILIZATION LOT NO. 2061.| 1) MODEL 300-20 NCP BIPOLAR LEAD,