FDA Adverse Event Injury Summary report: N

VERCISE GENUS

MDR report key: 17101919 · Received June 10, 2023

Report

Report Number
3006630150-2023-03296
Event Type
Injury
Date Received
June 10, 2023
Date of Event
May 19, 2023
Report Date
November 20, 2023
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
NHL
UDI-DI
08714729985044
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

BLOCK B3: APPROXIMATED BASED ON THE DATE THE MANUFACTURER BECAME AWARE OF THE EVENT.

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: PRODUCT FAMILY: DBS-LINEAR LEADS, UPN: M365DB2202300, MODEL: DB-2202-30, SERIAL: (B)(6), BATCH: (B)(6). PRODUCT FAMILY: DBS-LINEAR LEADS, UPN: M365DB2202300, MODEL: DB-2202-30, SERIAL: (B)(6), BATCH: (B)(6).

Description of Event or Problem · 0

IT WAS REPORTED THE PATIENT EXPERIENCED AN INFECTION AFTER BEING IMPLANTED WITH THE DEEP BRAIN STIMULATION (DBS) SYSTEM. THE PATIENT UNDERWENT A PROCEDURE WHERE PART OF THE DBS SYSTEM WAS REMOVED. NO FURTHER INFORMATION HAS BEEN OBTAINED DESPITE GOOD FAITH EFFORTS.

Description of Event or Problem · 0

IT WAS REPORTED THE PATIENT EXPERIENCED AN INFECTION AFTER BEING IMPLANTED WITH THE DEEP BRAIN STIMULATION (DBS) SYSTEM. THE PATIENT UNDERWENT A PROCEDURE WHERE PART OF THE DBS SYSTEM WAS REMOVED. NO FURTHER INFORMATION HAS BEEN OBTAINED DESPITE GOOD FAITH EFFORTS. ADDITIONAL INFORMATION WAS RECEIVED THAT BOTH LEADS WERE ALSO INFECTED. CULTURES TAKEN WERE POSITIVE FOR COAGULASE V AND STAPHYLOCOCCUS AUREUS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
452249 VERCISE GENUS STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN SYMPTOMS NHL BOSTON SCIENTIFIC NEUROMODULATION DB-1216 542876 08714729985044

Patients

Seq Age Sex Outcome Treatment
1 Unknown Required Intervention