FDA Adverse Event Injury Summary report: N

PRECISION

MDR report key: 1221248 · Received November 5, 2008

Report

Report Number
2029203-2008-00751
Event Type
Injury
Date Received
November 5, 2008
Date of Event
August 7, 2008
Report Date
October 6, 2008
Manufacturer
BOSTON SCIENTIFIC COPR
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 FOR EVAL, AS IT WAS DISCARDED BY THE MEDICAL FACILITY.

Description of Event or Problem · 1

A REPORT WAS REC'D THAT A PT HAD AN UNCOMFORTABLE POCKET SITE DUE TO HAVING LITTLE BODY FAT. THE DECISION WAS MADE TO EXPLANT THE PT'S PRECISION SYS.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention