InjuryLHG

LEAD DELIVERY SYS, 19CM (7.5 IN), 1 EACH

Received Sep 24, 2015 · Event occurred Aug 28, 2015

Report 1627487-2015-07563 · MDR key 5101426

Device

Generic name

Scs Epiducer

Manufacturer

St. Jude Medical - Neuromodulation

Model number

1773

Lot number

5077236

Product problems

Adverse Event Without Identified Device or Use Problem

Patient

58 YR

No Known Impact Or Consequence To Patient

Narrative

Additional Manufacturer Narrative

(B)(4). SJM HAS LIMITED INFORMATION RELATED TO THE PATIENT¿S MEDICAL HISTORY AND IS UNABLE TO FORM AN OPINION AS TO THE RELEVANCY OF THE PATIENT¿S HISTORY TO THE EVENT REPORTED. SJM DEFERS TO THE PATIENT¿S PHYSICIAN REGARDING MEDICAL HISTORY. UDI (DI): (B)(4).

Description of Event or Problem

DEVICE 2 OF 3. REFERENCE MFR REPORT #: 1627487-2015-07562 AND 1627487-2015-07564.