FDA Adverse Event Injury Summary report: N

VERCISE GENUS

MDR report key: 17656371 · Received August 30, 2023

Report

Report Number
3006630150-2023-05194
Event Type
Injury
Date Received
August 30, 2023
Date of Event
January 17, 2023
Report Date
October 11, 2024
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
NHL
PMA / PMN Number
P150031
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
NURSE
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ANALYSIS OF THE RETURNED LEAD EXTENSION DB-3128-55 ((B)(6)) REVEALED THAT AN X-RAY INSPECTION SHOWED CONTACTS 5 AND 8 OF THE PROXIMAL END OF THE LEAD EXTENSION HAD FRACTURED CABLES AT THE RIGHT WELD NUGGET. THE STRANDED CABLES APPEARED TO HAVE BEEN DAMAGED DURING THE MANUFACTURING PROCESS, POTENTIALLY AT THE WELDING OPERATION, RESULTING IN A WEAK WELD CONNECTION. THEREFORE, THE CAUSE OF THE EVENT IS ATTRIBUTED TO A MANUFACTURING DEFICIENCY.

Additional Manufacturer Narrative · 0

ANALYSIS OF THE RETURNED LEAD EXTENSION DB-3128-55 (5000197) REVEALED THAT AN X-RAY INSPECTION FOUND THAT MULTIPLE CABLES WERE FRACTURED CLOSE TO THE RETENTION SLEEVE. THE FRACTURED CABLES RESULTED IN THE REPORTED HIGH IMPEDANCES. THE FRACTURES ARE LIKELY DUE TO MECHANICAL STRESS FROM POSSIBLE FLEXING OF THE LEAD EXTENSION BODY. THEREFORE, THE CAUSE IS TRACED TO COMPONENT FAILURE.

Additional Manufacturer Narrative · 0

ANALYSIS OF THE RETURNED LEAD EXTENSION DB-3128-55 (5000197) REVEALED THAT AN X-RAY INSPECTION FOUND THAT MULTIPLE CABLES WERE FRACTURED CLOSE TO THE RETENTION SLEEVE. THE FRACTURED CABLES RESULTED IN THE REPORTED HIGH IMPEDANCES. ALTHOUGH THE POTENTIAL CAUSE OF THE OBSERVED HIGH IMPEDANCE HAS BEEN IDENTIFIED, THE NATURE OF HOW THE PROXIMAL TAIL BODY OR THE CABLES WITHIN THE BODY FRACTURED, IS UNKNOWN. FURTHER INVESTIGATION IS REQUIRED TO ASSESS THE ROOT CAUSE. THE PROBABLE CAUSE IS CAUSE NOT ESTABLISHED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE DEEP BRAIN STIMULATION (DBS) PATIENT EXPERIENCED HIGH IMPEDANCES ON THE LEAD EXTENSION. THE PATIENT UNDERWENT A LEAD EXTENSION REPLACEMENT PROCEDURE. THE PATIENT WAS DOING WELL POST-OPERATIVELY.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE DEEP BRAIN STIMULATION (DBS) PATIENT EXPERIENCED HIGH IMPEDANCES ON THE LEAD EXTENSION. THE PATIENT UNDERWENT A LEAD EXTENSION REPLACEMENT PROCEDURE. THE PATIENT WAS DOING WELL POST-OPERATIVELY.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE DEEP BRAIN STIMULATION (DBS) PATIENT EXPERIENCED HIGH IMPEDANCES ON THE LEAD EXTENSION. THE PATIENT UNDERWENT A LEAD EXTENSION REPLACEMENT PROCEDURE. THE PATIENT WAS DOING WELL POST-OPERATIVELY.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE DEEP BRAIN STIMULATION (DBS) PATIENT EXPERIENCED HIGH IMPEDANCES ON THE LEAD EXTENSION. THE PATIENT UNDERWENT A LEAD EXTENSION REPLACEMENT PROCEDURE. THE PATIENT WAS DOING WELL POST-OPERATIVELY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1184043 VERCISE GENUS STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN SYMPTOMS NHL BOSTON SCIENTIFIC NEUROMODULATION DB-3128-55 5000197

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention