FDA Adverse Event Injury Summary report: N

WAVEWRITER ALPHA

MDR report key: 18427546 · Received January 2, 2024

Report

Report Number
3006630150-2023-08289
Event Type
Injury
Date Received
January 2, 2024
Date of Event
December 1, 2023
Report Date
April 15, 2024
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
UDI-DI
08714729985099
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

BLOCK B3: APPROXIMATED BASED ON THE DATE THE MANUFACTURER BECAME AWARE OF THE EVENT. ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-LINEAR LEADS UPN: M365SC2218700 MODEL: SC-2218-70 SERIAL: (B)(6). BATCH: 7091001/7092783/7091333/7091247

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT WAS ADMITTED TO THE HOSPITAL DUE TO CHRONIC INFECTION. SIGNS AND SYMPTOMS OF PAIN, REDNESS AND WOUND DEHISCENCE WERE NOTED. THE PHYSICIAN REPORTED THAT THE INFECTION WAS NOT DUE TO DEVICE AND THAT THE PATIENT WAS DIABETIC AND TAKING IMMUNOSUPPRESSANTS. THE PATIENT UNDERWENT AN EXPLANT PROCEDURE AND WAS DOING WELL POSTOPERATIVELY WITH ANTIBIOTICS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT WAS ADMITTED TO THE HOSPITAL DUE TO CHRONIC INFECTION. SIGNS AND SYMPTOMS OF PAIN, REDNESS AND WOUND DEHISCENCE WERE NOTED. THE PHYSICIAN REPORTED THAT THE INFECTION WAS NOT DUE TO DEVICE AND THAT THE PATIENT WAS DIABETIC AND TAKING IMMUNOSUPPRESSANTS. THE PATIENT UNDERWENT AN EXPLANT PROCEDURE AND WAS DOING WELL POSTOPERATIVELY WITH ANTIBIOTICS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1418841 WAVEWRITER ALPHA STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1232 570487 08714729985099

Patients

Seq Age Sex Outcome Treatment
1 70 YR Male Required Intervention