FDA Adverse Event Death Summary report: N

PULSE GEN MODEL 102

MDR report key: 861006 · Received June 6, 2007

Report

Report Number
1644487-2007-00767
Event Type
Death
Date Received
June 6, 2007
Date of Event
January 8, 2007
Report Date
May 7, 2007
Manufacturer
CYBERONICS, INC.
Product Code
LYJ
PMA / PMN Number
P970003
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

INITIAL REPORTER INDICATED THAT A VNS PT HAD DIED DUE TO A "SEIZURE DISORDER ". HE INDICATED THAT THE DEATH WAS RELATED TO SUDEP, "BECAUSE EVERYTHING ELSE HAS BEEN RULED OUT." HE DID NOT BELIEVE THAT THE VNS CAUSED OR CONTRIBUTED TO THE PT'S DEATH.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PULSE GEN MODEL 102 LYJ CYBERONICS, INC. 102

Patients

Seq Age Sex Outcome Treatment
1 YR Other