MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2020-03-31 for PRODIGY MRI IPG, 16CH, RECHARGEABLE 3772 manufactured by St. Jude Medical - Neuromodulation.
[186018737]
Date of event is estimated. During processing of this complaint, attempts were made to obtain complete event information. The results/method and conclusion codes along with investigation results will be provided in the final report.
Patient Sequence No: 1, Text Type: N, H10
[186018738]
It was reported the patient was unable to charge the ipg just prior to a lead revision (please see reference mfr report#: 1627487-2020-02686), and ipg would not communicate with other external devices, either. Further information revealed the patient last recharged the ipg in (b)(6) 2019, and last had stimulation in (b)(6) 2019, but exact dates are unknown. To address the issue, the physician explanted and replaced the ipg with a new model, which resolved the issue.
Patient Sequence No: 1, Text Type: D, B5
[188744119]
The results of the investigation are inconclusive since the device was not returned for analysis. Based on the information received, the cause of the reported incident could not be conclusively determined.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 1627487-2020-03491 |
| MDR Report Key | 9908210 |
| Report Source | COMPANY REPRESENTATIVE,FOREIG |
| Date Received | 2020-03-31 |
| Date of Report | 2020-03-31 |
| Date of Event | 2019-11-01 |
| Date Mfgr Received | 2020-03-11 |
| Device Manufacturer Date | 2017-03-08 |
| Date Added to Maude | 2020-03-31 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | ANDREA DEITZ |
| Manufacturer Street | 6901 PRESTON ROAD |
| Manufacturer City | PLANO TX 75024 |
| Manufacturer Country | US |
| Manufacturer Postal | 75024 |
| Manufacturer Phone | 9723098000 |
| Manufacturer G1 | ST. JUDE MEDICAL - NEUROMODULATION |
| Manufacturer Street | 6901 PRESTON RD |
| Manufacturer City | PLANO TX 75024 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 75024 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | PRODIGY MRI IPG, 16CH, RECHARGEABLE |
| Generic Name | SCS IPG |
| Product Code | LGW |
| Date Received | 2020-03-31 |
| Model Number | 3772 |
| Catalog Number | 3772 |
| Lot Number | 5882950 |
| Device Expiration Date | 2019-03-08 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ST. JUDE MEDICAL - NEUROMODULATION |
| Manufacturer Address | 6901 PRESTON RD PLANO TX 75024 US 75024 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2020-03-31 |