FDA Adverse Event Other Summary report: N

PULSE GEN MODEL 101

MDR report key: 785944 · Received November 21, 2006

Report

Report Number
1644487-2006-00427
Event Type
Other
Date Received
November 21, 2006
Date of Event
October 26, 2006
Report Date
October 30, 2006
Manufacturer
CYBERONICS, INC.
Product Code
LYJ
PMA / PMN Number
P970003
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

REPORTER STATED NCP SYSTEM UNRELATED TO DEATH EVENT.

Description of Event or Problem · 1

REPORTER STATED THAT PATIENT WAS FOUND DEAD IN THEIR BED BY CAREGIVER. CAUSE OF DEATH IS UNKNOWN AND NO AUTOPSY WILL BE DONE. MANUFACTURER HAS DETERMINED THAT SUDEP IS PROBABLE. THE REPORTER HAS STATED THE NCP SYSTEM WAS UNRELATED TO THE DEATH.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PULSE GEN MODEL 101 LYJ LYJ CYBERONICS, INC. 101 7630

Patients

Seq Age Sex Outcome Treatment
1 19 YR Other