FDA Adverse Event Other Summary report: N

PULSE GEN MODEL 10X

MDR report key: 853046 · Received May 18, 2007

Report

Report Number
1644487-2007-00635
Event Type
Other
Date Received
May 18, 2007
Date of Event
April 1, 2007
Report Date
April 19, 2007
Manufacturer
CYBERONICS, INC.
Product Code
LYJ
PMA / PMN Number
P970003
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEATH OCCURRED BUT IS NOT SUSPECTED TO BE RELATED TO VNS THERAPY. DEVICE FAILURE IS NOT SUSPECTED.

Description of Event or Problem · 1

REPORTER INDICATED THAT A PATIENT PASSED AWAY. FROM THE INFORMATION AVAILABLE TO THE TREATIING PHYSICIAN, HE BELIEVES THE CAUSE OF DEATH WAS FROM CHOKING, HOWEVER, THE CAUSE OF DEATH LISTED ON THE DEATH CERTIFICATE IS SUDEP (SUDDEN UNEXPLAINED DEATH IN EPILEPSY).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PULSE GEN MODEL 10X LYJ CYBERONICS, INC. 10X

Patients

Seq Age Sex Outcome Treatment
1 YR Other