FDA Adverse Event
Injury
Summary report: N
LINEAR ST
MDR report key: 17341729
·
Received July 18, 2023
Report
- Report Number
- 3006630150-2023-04183
- Event Type
- Injury
- Date Received
- July 18, 2023
- Date of Event
- April 23, 2023
- Report Date
- July 18, 2023
- Manufacturer
- BOSTON SCIENTIFIC NEUROMODULATION
- Product Code
- LGW
- UDI-DI
- 08714729767725
- PMA / PMN Number
- P030017
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TN, US
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
BLOCK B3: EXACT DATE UNKNOWN, EVENT OCCURRED ABOUT TWO MONTHS AGO, BASED ON THE DATE THE MANUFACTURER BECAME AWARE OF THE EVENT. ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-LINEAR LEADS, UPN: M365SC2218500, MODEL: SC-2218-550, SERIAL: (B)(6), BATCH: 7083310.
Description of Event or Problem · 0
IT WAS REPORTED THAT PATIENTS WERE HAVING HIGH IMPEDANCES OF ONE IN ITS LEADS. THE PATIENT UNDERWENT A LEAD REPLACEMENT PROCEDURE AND PATIENT WAS DOING WELL POSTOPERATIVELY. THE EXPLANTED LEADS WERE REPLACED AND WERE DISCARDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 765421 | LINEAR ST | STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF | LGW | BOSTON SCIENTIFIC NEUROMODULATION | SC-2218-50 | 7083308 | 08714729767725 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 47 YR | Female | Required Intervention |