FDA Adverse Event
Injury
Summary report: N
IB-STIM
MDR report key: 17246912
·
Received June 30, 2023
Report
- Report Number
- MW5119046
- Event Type
- Injury
- Date Received
- June 30, 2023
- Date of Event
- June 14, 2023
- Report Date
- June 28, 2023
- Manufacturer
- NEURAXIS, INC.
- Product Code
- QHH
- Adverse Event
- Yes
- Report Source
- Voluntary report
- Reporter Location
- TX, US
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
Description of Event or Problem · 0
PATIENT WITH SYMPTOMS OF WORSENING HEADACHE, BACK PAIN, DIZZINESS WITH SECOND DEVICE (NEURAXIS IB-STIM) PLACEMENT. SYMPTOMS RESOLVED AFTER DEVICE REMOVAL. REFERENCE REPORT: MW5119047.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2040588 | IB-STIM | NON-IMPLANTED NERVE STIMULATOR FOR PAIN ASSOCIATED WITH IRRITABLE BOWEL SYNDROME | QHH | NEURAXIS, INC. | 969701 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 17 YR | Female |