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