FDA Adverse Event Other Summary report: N

PULSE GEN MODEL 101

MDR report key: 776249 · Received November 2, 2006

Report

Report Number
1644487-2006-00413
Event Type
Other
Date Received
November 2, 2006
Date of Event
July 20, 2006
Report Date
September 27, 2006
Manufacturer
CYBERONICS, INC.
Product Code
LYJ
PMA / PMN Number
P970003
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
DA
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

REPORTER INDICATED THAT VNS PT HAD PASSED AWAY. TREATING PHYSICIAN INDICATED THE CAUSE OF DEATH WAS MOST LIKELY SUDEP (SUDDEN UNEXPLAINED DEATH IN EPILEPSY). TREATING PHYSICIAN INDICATED THAT THE NCP SYSTEM WAS NOT RELATED TO THE CAUSE OF DEATH. NO AUTOPSY WILL BE PERFORMED. THERE IS NO INDICATION THAT THE DEVICE WAS NOT FUNCTIONING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PULSE GEN MODEL 101 LYJ LYJ CYBERONICS, INC. 101 4813

Patients

Seq Age Sex Outcome Treatment
1 34 YR Other