FDA Adverse Event Injury Summary report: N

OCTRODE LEAD KIT, 60CM LENGTH

MDR report key: 18384829 · Received December 22, 2023

Report

Report Number
1627487-2023-06051
Event Type
Injury
Date Received
December 22, 2023
Date of Event
November 16, 2023
Report Date
February 7, 2024
Manufacturer
ABBOTT MEDICAL
Product Code
LGW
PMA / PMN Number
P010032
Report Source
Manufacturer report
Reporter Location
NE, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE RESULTS OF THE INVESTIGATION ARE INCONCLUSIVE SINCE THE DEVICE WAS NOT RETURNED FOR ANALYSIS. BASED ON THE INFORMATION RECEIVED, THE CAUSE OF THE REPORTED INCIDENT COULD NOT BE CONCLUSIVELY DETERMINED.

Additional Manufacturer Narrative · 0

DURING PROCESSING OF THIS INCIDENT, ATTEMPTS WERE MADE TO OBTAIN COMPLETE EVENT AND PATIENT INFORMATION. FURTHER INFORMATION WAS REQUESTED BUT NOT RECEIVED. ADDITIONAL COMPONENTS POTENTIALLY INVOLVED IN THE EVENT INCLUDE: COMMON DEVICE NAME: SCS LEAD, MODEL: 3166, UDI: (B)(4), SERIAL: (B)(6), BATCH: 5030692.

Description of Event or Problem · 0

ADDITIONAL INFORMATION REVEALED THAT THE PATIENT UNDERWENT SURGICAL INTERVENTION WHEREIN THE LEADS WERE EXPLANTED AND REPLACED. POSTOPERATIVELY, THE PATIENT HAS EFFECTIVE THERAPY.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT IS EXPERIENCING INEFFECTIVE THERAPY AS A RESULT OF AN IMPEDANCE ISSUE. SURGICAL INTERVENTION MAY BE PENDING TO ADDRESS THE ISSUE. INVESTIGATION WAS UNABLE TO DETERMINE WHICH OF THE LEADS ATTRIBUTED TO THE EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1298954 OCTRODE LEAD KIT, 60CM LENGTH STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW ABBOTT MEDICAL 3186 4365527

Patients

Seq Age Sex Outcome Treatment
1 NA Male SCS IPG (X1)| SCS LEAD (X1)