Brand Name | SENTIVA GENERATOR |
Type of Device | STIMULATOR, AUTONOMIC NERVE, IMPLANTED FOR EPILEPSY |
Manufacturer (Section D) |
CYBERONICS / LIVANOVA USA, INC. |
|
|
MDR Report Key | 16086061 |
MDR Text Key | 306608267 |
Report Number | MW5114106 |
Device Sequence Number | 1 |
Product Code |
LYJ
|
Combination Product (y/n) | N |
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Voluntary
|
Reporter Occupation |
Patient Family Member or Friend
|
Type of Report
| Initial |
Report Date |
12/27/2022 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 12/30/2022 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Model Number | 1000 |
Device Lot Number | 204895 |
Was Device Available for Evaluation? |
Yes
|
Patient Sequence Number | 1 |
Treatment | ALLEGRAA; B12; BRIVIACT NEBULIZER MACHINE ; CARBAMEPAZINE ; GABEPENTIN; KEPPRA; TROKENDI ; VITAMIN D3 ; WHEELCHAIRBOUND; XANEX,DICYCLOMINE; XOPONEX AS WELL AS THE INHALER |
Patient Outcome(s) |
Required Intervention;
Hospitalization;
Life Threatening;
Other;
Disability;
|
Patient Age | 38 YR |
Patient Sex | Female |
Patient Weight | 86 KG |
Patient Ethnicity | Non Hispanic |
Patient Race | White |
|
|