FDA Adverse Event Injury Summary report: N

PRECISION

MDR report key: 1230015 · Received November 12, 2008

Report

Report Number
2029203-2008-00781
Event Type
Injury
Date Received
November 12, 2008
Date of Event
June 9, 2008
Report Date
October 13, 2008
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
LGW
PMA / PMN Number
P030017
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE EXPLANTED DEVICES WILL NOT BE EVALUATED AS THEY WERE DISCARDED BY THE MEDICAL FACILITY.

Description of Event or Problem · 1

A REPORT WAS RECEIVED OF A PRECISION SYSTEM EXPLANT. THE SYSTEM WAS EXPLANTED, DUE TO SKIN EROSION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PRECISION SPINAL CORD STIMULATOR LGW BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SC-1110 N/A

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention LINEAR LEAD