FDA Adverse Event Injury Summary report: N

VERCISE GENUS

MDR report key: 17695727 · Received September 6, 2023

Report

Report Number
3006630150-2023-05369
Event Type
Injury
Date Received
September 6, 2023
Date of Event
July 21, 2023
Report Date
November 17, 2023
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
NHL
UDI-DI
08714729985044
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT: PRODUCT FAMILY: DBS-EXTENSION. UPN: M365NM3138550. MODEL: NM-3138-55. SERIAL: (B)(6). BATCH: 7091693. PRODUCT FAMILY: DBS-EXTENSION. UPN: M365NM3138550. MODEL: NM-3138-55. SERIAL: (B)(6). BATCH: 7091358. CORRECTION TO FOLLOW-UP 1 MDR IN FIELD B5.

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT: PRODUCT FAMILY: DBS-EXTENSION UPN: M365NM3138550. MODEL: NM-3138-55. SERIAL: (B)(6). BATCH: 7091693. PRODUCT FAMILY: DBS-EXTENSION UPN: M365NM3138550 . MODEL: NM-3138-55. SERIAL: (B)(6). BATCH: 7091358.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE DEEP BRAIN STIMULATION (DBS) PATIENT EXPERIENCED DEHISCENCE, EXPOSURE OF THEIR IMPLANT, AND AN INFECTION AT THEIR IMPLANTABLE PULSE GENERATOR (IPG) INCISION SITE. THE PATIENT WAS ADMINISTERED ORAL STEROIDS AND A TOPICAL ANTISEPTIC AS WELL AS UNDERWENT AN EXPLANT PROCEDURE WHERE THE IPG AND LEAD EXTENSIONS WERE REMOVED. THE PATIENT WAS DOING WELL POST-OPERATIVELY. THE DEVICES WERE DISCARDED AND WILL NOT BE RETURNED FOR ANALYSIS. ADDITIONAL INFORMATION WAS RECEIVED THAT THE LEAD EXTENSIONS HAD BEEN CUT AT THE IPG POCKET SITE AND PARTIALLY REMOVED DURING THE EXPLANT PROCEDURE. THE PATIENT THEN UNDERWENT AN ADDITIONAL PROCEDURE WHERE THE REMAINING PORTIONS OF THE LEAD EXTENSIONS WERE EXPLANTED. THERE WERE NO REPORTED COMPLICATIONS POST OPERATIVELY.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE DEEP BRAIN STIMULATION (DBS) PATIENT EXPERIENCED DEHISCENCE, EXPOSURE OF THEIR IMPLANT, AND AN INFECTION AT THEIR IMPLANTABLE PULSE GENERATOR (IPG) INCISION SITE. THE PATIENT WAS ADMINISTERED ORAL STEROIDS AND A TOPICAL ANTISEPTIC AS WELL AS UNDERWENT AN EXPLANT PROCEDURE WHERE THE IPG WAS REMOVED. THE PATIENT IS DOING WELL POST-OPERATIVELY. THE DEVICE WAS DISCARDED AND WILL NOT BE RETURNED FOR ANALYSIS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE DEEP BRAIN STIMULATION (DBS) PATIENT EXPERIENCED DEHISCENCE, EXPOSURE OF THEIR IMPLANT, AND AN INFECTION AT THEIR IMPLANTABLE PULSE GENERATOR (IPG) INCISION SITE. THE PATIENT WAS ADMINISTERED ORAL STEROIDS AND A TOPICAL ANTISEPTIC AS WELL AS UNDERWENT AN EXPLANT PROCEDURE WHERE THE IPG WAS REMOVED. THE PATIENT IS DOING WELL POST-OPERATIVELY. THE DEVICE WAS DISCARDED AND WILL NOT BE RETURNED FOR ANALYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1122606 VERCISE GENUS STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN SYMPTOMS NHL BOSTON SCIENTIFIC NEUROMODULATION DB-1216 524033 08714729985044

Patients

Seq Age Sex Outcome Treatment
1 70 YR Male Required Intervention