FDA Adverse Event Malfunction Summary report: N

INTELLIS

MDR report key: 7420299 · Received April 10, 2018

Report

Report Number
3004209178-2018-07754
Event Type
Malfunction
Date Received
April 10, 2018
Date of Event
April 5, 2018
Report Date
November 5, 2018
Manufacturer
MEDTRONIC PUERTO RICO OPERATIONS CO.
Product Code
LGW
UDI-DI
00643169781702
PMA / PMN Number
P840001
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 1

ADDITIONAL INFORMATION WAS RECEIVED FROM THE MANUFACTURER REPRESENTATIVE ON 2018-APR-11 REPORTING THAT THE PATIENT TURNED STIMULATION OFF ONCE THEY COULD NO LONGER TOLERATE THE SENSATION AT THE BATTERY SITE. THE CAUSE HAD NOT BEEN DETERMINED AT THIS TIME. THE PATIENT WOULD BE MAKING AN APPOINTMENT IN THE FUTURE WITH THE MANUFACTURER REPRESENTATIVE. NO FURTHER COMPLICATIONS WERE REPORTED.

Description of Event or Problem · 1

INFORMATION WAS RECEIVED FROM A CONSUMER VIA A MANUFACTURER REPRESENTATIVE REGARDING A PATIENT WHO WAS IMPLANTED WITH A NEUROSTIMULATOR FOR NON-MALIGNANT PAIN. IT WAS REPORTED THAT THE IMPLANT SITE FELT HOT AND IT WAS ALSO FROM THE MIDDLE OF THEIR BACK DOWN TO THEIR GROIN. THIS OCCURRED THE DAY BEFORE THE REPORT (B)(6) 2018. THE THERAPY WAS TURNED ON EARLIER YESTERDAY BUT THEY FELT IT LATER IN THE EVENING. IT WAS REPORTED THAT THE PATIENT DID NOT APPEAR TO HAVE SYMPTOMS WHEN THERAPY WAS OFF. IMPEDANCES WERE NOT CHECKED AT THE TIME OF THE REPORT. THE MANUFACTURER REPRESENTATIVE WAS GOING TO MEET WITH THE PATIENT NEXT MONDAY TO CHECK THE SYSTEM. ADDITIONAL INFORMATION WAS RECEIVED FROM THE MANUFACTURER REPRESENTATIVE ON (B)(6) 2018 WHEN THEY WERE WITH THE PATIENT. IMPEDANCES WERE FINE WITH A RANGE AROUND 780-1350 OHMS WHILE CHECKING DIFFERENT REFERENCE ELECTRODES. THE PATIENT DID SOMETIMES FELL STIMULATION WHEN THE INS WAS OFF. THE INS STARTED FEELING HOT AFTER IT HAD BEEN ON FOR ABOUT 30 MINUTES. THIS WAS CONFIRMED IN THE OFFICE WHEN THE INS HAD BEEN ON FOR ABOUT 25 MINUTES WHEN THE MANUFACTURER REPRESENTATIVE HAD TO TURN THE INS OFF SINCE THE PATIENT BEGAN TO FEEL THE SENSATION. WHEN THE INS WAS TURNED ON, THE PATIENT FELT STIMULATION APPROPRIATELY. THE PATIENT INDICATED THAT THE SENSATION FELT LIKE POST-OP PAIN FROM WHEN THE INS WAS FIRST REPLACED. THE PATIENT HAD NOT NOTICED ANY REDNESS OR SWELLING AT THE INS SITE BEYOND SWELLING RIGHT AFTER REPLACEMENT. THE INCISION WAS EXAMINED BY THE HCP LAST THURSDAY AND NO ISSUES WERE SAID TO BE FOUND. NO FURTHER COMPLICATIONS WERE REPORTED.

Description of Event or Problem · 1

ADDITIONAL INFORMATION WAS RECEIVED FROM THE PATIENT VIA MANUFACTURER'S REPRESENTATIVE. IT WAS REPORTED PATIENT FELT BURNING SENSATION AT STIMULATOR POCKET SITE AND GOT VERY HOT WHEN PATIENT TURNED INS ON. IT WAS REPORTED THE BURNING SENSATION STARTED INCREASING 10 MINUTES AFTER INS WAS ON.

Description of Event or Problem · 1

ADDITIONAL INFORMATION WAS RECEIVED FROM A MANUFACTURER REPRESENTATIVE (REP) REPORTING THAT THE REP WAS UNSURE AT THIS TIME IF ANY FURTHER ACTIONS/INTERVENTIONS WOULD BE TAKEN TO RESOLVE THE PATIENT¿S BURNING SENSATION AT THE INS SITE. THE PATIENT WAS RESCHEDULING TO SEE THEIR HEALTHCARE PROVIDER (HCP) TO DISCUSS THIS, BUT THE APPOINTMENT DATE WAS UNKNOWN AT THIS TIME. IT WAS INDICATED THAT THE PROVIDED INFORMATION HAD BEEN CONFIRMED WITH THE PHYSICIAN. NO FURTHER COMPLICATIONS WERE REPORTED/ANTICIPATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
254505 INTELLIS STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW MEDTRONIC PUERTO RICO OPERATIONS CO. 97715 00643169781702

Patients

Seq Age Sex Outcome Treatment
1 52 YR