FDA Adverse Event Injury Summary report: N

WAVEWRITER ALPHA 16

MDR report key: 16484009 · Received March 6, 2023

Report

Report Number
3006630150-2023-01040
Event Type
Injury
Date Received
March 6, 2023
Date of Event
February 13, 2023
Report Date
April 13, 2023
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
UDI-DI
08714729985082
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

APPROXIMATED BASED ON THE DATE THE MANUFACTURER BECAME AWARE OF THE EVENT. ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-LINEAR LEADS, UPN: M365SC2218500, MODEL: SC-2218-50, SERIAL: (B)(4), BATCH: 7100009/7100010.

Additional Manufacturer Narrative · 0

SC-1216 SN: (B)(6). THE RETURNED IPG WAS ANALYZED, PASSED ALL TESTS PERFORMED, AND EXHIBITED NORMAL DEVICE CHARACTERISTICS. THE REPORTED EVENT WAS NOT CONFIRMED. THE IPG EXHIBITS NORMAL CHARACTERISTICS DURING THE ANALYSIS. HOWEVER, A LABELING REVIEW FOUND THAT THE REPORTED EVENT OF BURNING SENSATION DESPITE REPROGRAMMING IS A KNOWN RISK ASSOCIATED WITH THE USE OF AN IMPLANTABLE PULSE GENERATOR AS PART OF A SYSTEM TO DELIVER SPINAL CORD STIMULATION. THEREFORE, THIS INVESTIGATION IS ASSIGNED A PROBABLE CAUSE OF KNOWN INHERENT RISK OF DEVICE.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT WAS EXPERIENCING BURNING SENSATION DESPITE REPROGRAMMING DONE. THE PATIENT UNDERWENT AN EXPLANT PROCEDURE.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT WAS EXPERIENCING BURNING SENSATION DESPITE REPROGRAMMING DONE. THE PATIENT UNDERWENT AN EXPLANT PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1512348 WAVEWRITER ALPHA 16 STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1216 526715 08714729985082

Patients

Seq Age Sex Outcome Treatment
1 78 YR Unknown Required Intervention