BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PRECISION

    MDR report key: 1150232 · Received September 3, 2008

    Report

    Report Number
    2029203-2008-00588
    Event Type
    Injury
    Date Received
    September 3, 2008
    Date of Event
    August 4, 2008
    Report Date
    August 4, 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
    US
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    ADD'L SUSPECT MEDICAL DEVICE PRODS INVOLVED IN THE EVENT: MODEL # SC-2138-50. LINEAR LEAD (PHASE IIIA), 50 CM. MODEL # SC-2138-50. LINEAR LEAD (PHASE IIIA), 50 CM.

    Description of Event or Problem · 1

    A COMPLAINT OF PAIN AT THE POCKET SITE AND INADEQUATE PAIN COVERAGE WAS REPORTED. THE PT IS REQUESTING TO HAVE HER SYS REMOVED.

    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