FDA Adverse Event
Injury
Summary report: N
PRECISION
MDR report key: 1220490
·
Received November 4, 2008
Report
- Report Number
- 2029203-2008-00874
- Event Type
- Injury
- Date Received
- November 4, 2008
- Report Date
- October 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
- US
- Reporter Occupation
- UNKNOWN
Narratives
Additional Manufacturer Narrative · 1
THE EXPLANTED DEVICES WILL NOT BE RETURNED AS THEY WERE DISCARDED BY THE MEDICAL FACILITY.
Description of Event or Problem · 1
A REPORT WAS REC'D STATING THAT A PATIENT'S PRECISION SYSTEM WAS EXPLANTED. IT WAS REPORTED THAT AFTER RECEIVING A SHOCK THE PT WAS SCARED TO USE THE SYSTEM AND DECIDED TO HAVE IT EXPLANTED.
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 | LINEAR LEAD| LINEAR LEAD |