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 |