FDA Adverse Event Injury Summary report: N

STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF

MDR report key: 17529703 · Received August 12, 2023

Report

Report Number
MW5136627
Event Type
Injury
Date Received
August 12, 2023
Report Date
January 29, 2010
Manufacturer
MEDTRONIC
Product Code
LGW
Report Source
Voluntary report
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 0

BOSTON SCIENTIFIC NEUROMODULATION (BSN) RECEIVED, INFORMATION ABOUT AN EVENT THAT WOULD HAVE BEEN REPORTABLE UNDER 21 CFR 803, MEDICAL DEVICE REPORTING WITHIN OUR COMPLAINT SYSTEM. HOWEVER, THE ISSUE REPORTED, WAS RELATED TO IMPLANTED SPINAL CORD STIMULATOR LEADS MANUFACTURED BY MEDTRONIC. A REPORT WAS RECEIVED, THAT DURING A PROCEDURE TO CONNECT MEDTRONIC LEADS TO THE BSN IMPLANTABLE PULSE GENERATOR (IPG), A BSN SALES REPRESENTATIVE NOTICED, THE MEDTRONIC LEADS WERE SHREDDED. THE PATIENT WAS RE-IMPLANTED WITH BSN LEADS AND IPG. AND THE PATIENT IS REPORTEDLY, DOING WELL. THE MEDTRONIC LEADS WERE NOT RETURNED TO BOSTON SCIENTIFIC NEUROMODULATION. THIS REPORT REFLECTS INFORMATION RECEIVED BY FDA IN THE FORM OF A NOTIFICATION PER 803.22 (B)(2).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1355275 STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW MEDTRONIC

Patients

Seq Age Sex Outcome Treatment
1 Unknown