BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PRECISION

    MDR report key: 1230990 · Received October 28, 2008

    Report

    Report Number
    2029203-2008-00921
    Event Type
    Malfunction
    Date Received
    October 28, 2008
    Date of Event
    September 24, 2008
    Report Date
    September 24, 2008
    Manufacturer
    BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
    Product Code
    LGW
    PMA / PMN Number
    P030017
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    A CUSTOMER SERVICE REPORT OF COMMUNICATION ISSUES BETWEEN THE IMPLANT THE EXTERNAL EQUIPMENT WAS RECEIVED. THE PROBLEM WAS CONFIRMED AND A REVISION SURGERY WAS RECOMMENDED. THE PT HAS DECIDED NOT TO MOVE FORWARD WITH A REVISION.

    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