FDA Adverse Event Injury Summary report: N

PRECISION

MDR report key: 1040026 · Received May 7, 2008

Report

Report Number
2029203-2008-00273
Event Type
Injury
Date Received
May 7, 2008
Date of Event
April 7, 2008
Report Date
April 7, 2008
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORP
Product Code
LGW
PMA / PMN Number
P030017
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE PT REPORTED DISCOMFORT AT THE POCKET SITE. THE SURGEON HAS DECIDED TO EXPLANT THE PT'S SYSTEM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PRECISION SPINAL CORD STIMULATOR LGW BOSTON SCIENTIFIC NEUROMODULATION CORP SC-1110 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention SC-3138-25| SC-2138-50| SC-2138-70