FDA Adverse Event Injury Summary report: N

INFINION 16

MDR report key: 16432359 · Received February 23, 2023

Report

Report Number
3006630150-2023-00804
Event Type
Injury
Date Received
February 23, 2023
Date of Event
February 1, 2023
Report Date
February 23, 2023
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
UDI-DI
08714729797807
PMA / PMN Number
P030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
LA, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-LINEAR LEADS, UPN: M365SC231650E0, MODEL: SC-231650E, SERIAL: (B)(4), BATCH: 7182325.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING A TRIAL, THE PATIENT HAD A PANIC ATTACK WHEN FEELING THE STIMULATION. THE PATIENT UNDERWENT A LEAD PULL AND THE PATIENT WAS DOING WELL AFTER. THE REMOVED LEADS WILL NOT BE RETURNED AS IT WAS DISCARDED BY THE MEDICAL FACILITY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
444563 INFINION 16 STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION SC-2316-50E 7182080 08714729797807

Patients

Seq Age Sex Outcome Treatment
1 62 YR Female Required Intervention