FDA Adverse Event Injury Summary report: N

DEEP BRAIN STIMULATION LEAD

MDR report key: 1025051 · Received March 31, 2008

Report

Report Number
2182207-2008-01706
Event Type
Injury
Date Received
March 31, 2008
Report Date
November 11, 2007
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
MHY
PMA / PMN Number
P960009
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT IS BEING SUBMITTED FOLLOWING AN INTERNAL AUDIT.

Description of Event or Problem · 1

LITERATURE: PARR "DEEP BRAIN STIMULATION IN CHILDHOOD: AN EFFECTIVE TREATMENT FOR EARLY ONSET IDIOPATHIC GENERALIZED DYSTONIA" 2007/92/8/708-11. CASE 3 HAS UNDERGONE OPERATIONS FOR LEAD DISPLACEMENT (CAUSED BY SLIDING DOWN STAIRS); SUBSEQUENTLY, THE UNIT REQUIRED REVISION DUE TO INFECTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DEEP BRAIN STIMULATION LEAD MHY MEDTRONIC NEUROMODULATION LEADMVD UNK

Patients

Seq Age Sex Outcome Treatment
1 8 YR Required Intervention IMPLANTED:| IMPLANTED:| IMPLANTED:| IMPLANTED:| EXPLANTED:| EXPLANTED:| IMPLANTED:| IMPLANTABLE PULSE GENERATOR MODEL IPGNEURO LOT#UNK| IMPLANTED:| EXPLANTED:| PROGRAMMER: MODEL PROGRAMMER, LOT # UNK| EXPLANTED:| LEAD: MODEL LEAD MVD, LOT,# UNK| EXPLANTED:| EXTENSION: MODEL EXTENSION MVD, LOT # UNK| IMPLANTABLE PULSE GENERATOR MODEL IPGNEURO LOT#UNK| EXPLANTED:| EXTENSION: MODEL EXTENSION MVD, LOT # UNK