FDA Adverse Event Injury Summary report: N

PRECISION

MDR report key: 18378006 · Received December 21, 2023

Report

Report Number
3006630150-2023-07993
Event Type
Injury
Date Received
December 21, 2023
Date of Event
December 7, 2020
Report Date
May 20, 2024
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
UDI-DI
08714729767688
PMA / PMN Number
P030017
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT PRODUCT FAMILY SCS-LINEAR LEADS UPN M365SC2218300. MODEL SC-2218-30. SERIAL- (B)(6). BATCH 202724 AND 202735. SC-1110-02, SERIAL (B)(6). ANALYSIS OF THE RETURNED IPG REVEALED NORMAL DEVICE CHARACTERISTICS AND WAS ABLE TO BE CHARGED IN ONE FOUR-HOUR CHARGE CYCLE WITHOUT ANY ANOMALIES AND PASSED ALL TESTING. HOWEVER, THE DATA LOG REVEALED THE THERMISTOR HAD BEEN TRIGGERED MULTIPLE TIMES AND THAT THE CHARGER MAY HAVE BEEN MISALIGNED WITH THE IPG. A PRODUCT LABELING REVIEW THAT WAS CONDUCTED DETERMINED THAT THE CHARGER SHOULD BE WELL VENTILATED AND SHOULD NOT BE USED IF THE AMBIENT TEMPERATURE EXCEEDS 35 DEGREES CELSIUS. THEREFORE, ENGINEERS CONCLUDED THE PROBABLE CAUSE OF THE EVENT WAS FAILURE TO FOLLOW THE INSTRUCTIONS FOR USE, IFU. SC-2218-30, SERIAL (B)(6). THE LEADS WERE DISPOSED OF AND WERE NOT RETURNED FOR ANALYSIS. THEREFORE, A PHYSICAL ANALYSIS HAS NOT BEEN CONDUCTED IN OUR LABORATORY. THERE WAS NO ALLEGATION AGAINST THE LEADS.

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT. PRODUCT FAMILY SCS-LINEAR LEADS: UPN M365SC2218300. MODEL SC-2218-30. SERIAL-LOT (B)(6) AND(B)(6). BATCH 202724 AND 202735.

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT PRODUCT FAMILY SCS-LINEAR LEADS, UPN M365SC2218300, MODEL SC-2218-30, SERIAL-LOT (B)(6), BATCH 202724 AND 202735.

Description of Event or Problem · 0

IT WAS REPORTED THAT APPROXIMATELY THREE YEARS AGO, THE PATIENTS SPINAL CORD STIMULATION (SCS) IMPLANTABLE PULSE GENERATOR (IPG) STOPPED WORKING. THE PATIENT EXPERIENCED DIFFICULTY CHARGING THE IPG, AND IT WOULD NO LONGER COMMUNICATE WITH THE REMOTE CONTROL. THE IPG BECAME COMPLETELY DEPLETED. THE PATIENT UNDERWENT A REVISION PROCEDURE IN WHICH THE PHYSICIAN REPLACED THE ENTIRE SYSTEM, WHICH CONSISTED OF ONE IPG AND TWO LEADS. THERE WERE NO COMPLICATIONS, AND THE NEW SYSTEM WORKS FINE. THE LEADS WILL NOT BE RETURNED AS THEY WERE DISCARDED AT THE HOSPITAL. ADDITIONAL INFORMATION WAS RECEIVED THAT THE MALFUNCTION WAS SUSPECTED TO BE THE IPG ONLY.

Description of Event or Problem · 0

IT WAS REPORTED THAT APPROXIMATELY THREE YEARS AGO, THE PATIENTS SPINAL CORD STIMULATION (SCS) IMPLANTABLE PULSE GENERATOR (IPG) STOPPED WORKING. THE PATIENT EXPERIENCED DIFFICULTY CHARGING THE IPG, AND IT WOULD NO LONGER COMMUNICATE WITH THE REMOTE CONTROL. THE IPG BECAME COMPLETELY DEPLETED. THE PATIENT UNDERWENT A REVISION PROCEDURE IN WHICH THE PHYSICIAN REPLACED THE ENTIRE SYSTEM, WHICH CONSISTED OF ONE IPG AND TWO LEADS. THERE WERE NO COMPLICATIONS, AND THE NEW SYSTEM WORKS FINE. THE LEADS WILL NOT BE RETURNED AS THEY WERE DISCARDED AT THE HOSPITAL. ADDITIONAL INFORMATION WAS RECEIVED THAT THE MALFUNCTION WAS SUSPECTED TO BE THE IPG ONLY.

Description of Event or Problem · 0

IT WAS REPORTED THAT APPROXIMATELY THREE YEARS AGO, THE PATIENTS SPINAL CORD STIMULATION (SCS) IMPLANTABLE PULSE GENERATOR (IPG) STOPPED WORKING. THE PATIENT EXPERIENCED DIFFICULTY CHARGING THE IPG, AND IT WOULD NO LONGER COMMUNICATE WITH THE REMOTE CONTROL. THE IPG BECAME COMPLETELY DEPLETED. THE PATIENT UNDERWENT A REVISION PROCEDURE IN WHICH THE PHYSICIAN REPLACED THE ENTIRE SYSTEM, WHICH CONSISTED OF ONE IPG AND TWO LEADS. THERE WERE NO COMPLICATIONS, AND THE NEW SYSTEM WORKS FINE. THE LEADS WILL NOT BE RETURNED AS THEY WERE DISCARDED AT THE HOSPITAL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
298472 PRECISION STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1110-02 195003 08714729767688

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention