FDA Adverse Event
Injury
Summary report: N
PRECISION
MDR report key: 1222014
·
Received November 6, 2008
Report
- Report Number
- 2029203-2008-00917
- Event Type
- Injury
- Date Received
- November 6, 2008
- Date of Event
- December 1, 2005
- Report Date
- October 7, 2008
- Manufacturer
- BOSTON SCIENTIFIC NEUROMODULATION CORPORATION.
- 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 DEVICE WILL NOT BE EVALUATED AS WAS DISCARDED BY THE MEDICAL FACILITY.
Description of Event or Problem · 1
A REPORT OF THE PATIENT'S PRECISION SYSTEM EXPLANTED DUE TO INFECTION WAS RECEIVED. NO FURTHER INFORMATION REGARDING THE INFECTION OR EXPLANT WAS AVAILABLE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | PRECISION | SPINAL CORD STIMULATOR | LGW | BOSTON SCIENTIFIC NEUROMODULATION CORPORATION. | SC-1110 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Required Intervention | MODEL # SC-2138-70| LINEAR LEAD |