FDA Adverse Event Injury Summary report: N

PRECISION MONTAGE MRI

MDR report key: 14691572 · Received June 15, 2022

Report

Report Number
3006630150-2022-02874
Event Type
Injury
Date Received
June 15, 2022
Date of Event
May 18, 2022
Report Date
July 20, 2022
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
UDI-DI
08714729905943
PMA / PMN Number
P030017
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-LINEAR LEADS-MRI, UPN: (B)(4), MODEL: SC-2408-56, SERIAL: UNK, BATCH: UNK. PRODUCT FAMILY: SCS-LINEAR LEADS-MRI, UPN: UNK-M-SC-2408-56, MODEL: SC-2408-56, SERIAL: UNK, BATCH: UNK.

Additional Manufacturer Narrative · 0

THE RETURNED IPG PASSED ALL TESTS PERFORMED AND REVEALED NORMAL DEVICE CHARACTERISTICS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE SPINAL CORD STIMULATION (SCS) PATIENT EXPERIENCED INADEQUATE STIMULATION. THE PATIENTS DEVICE WAS REPROGRAMMED SEVERAL TIMES, HOWEVER, THE REPORTED ISSUE PERSISTED. THE PATIENT UNDERWENT AN EXPLANT PROCEDURE WHERE ALL THE DEVICES WERE REMOVED. THE PATIENT WAS DOING WELL POST-OPERATIVELY.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE SPINAL CORD STIMULATION (SCS) PATIENT EXPERIENCED INADEQUATE STIMULATION. THE PATIENTS DEVICE WAS REPROGRAMMED SEVERAL TIMES, HOWEVER, THE REPORTED ISSUE PERSISTED. THE PATIENT UNDERWENT AN EXPLANT PROCEDURE WHERE ALL THE DEVICES WERE REMOVED. THE PATIENT WAS DOING WELL POST-OPERATIVELY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2807400 PRECISION MONTAGE MRI STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1200 350514 08714729905943

Patients

Seq Age Sex Outcome Treatment
1 Unknown Required Intervention