FDA Adverse Event Injury Summary report: N

EVOKE SCS SYSTEM

MDR report key: 18697209 · Received February 13, 2024

Report

Report Number
3021836309-2024-00194
Event Type
Injury
Date Received
February 13, 2024
Date of Event
January 17, 2024
Report Date
April 5, 2024
Manufacturer
SALUDA MEDICAL PTY LTD
Product Code
LGW
PMA / PMN Number
P190002
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

LEADS AND CLS ARE NOT AVAILABLE FOR ANALYSIS. WITHOUT THE DEVICES' RETURN, IT IS NOT POSSIBLE TO REACH A DEFINITIVE ROOT CAUSE REGARDING INADEQUATE THERAPY. IMPEDANCE LOGS REVEALED ALL ELECTRODES WERE WITHIN RANGE. THE CAUSE OF THE DEFORMED NON-ACTIVE BAND REMAINS UNCLEAR, ALTHOUGH THERAPY HAS RESUMED AFTER REVISION SURGERY WITH NO REPORTED ISSUES. THE MANUFACTURING RECORDS WERE REVIEWED. THE PRODUCT MET ALL REQUIREMENTS FOR RELEASE, WITH NO ANOMALIES IDENTIFIED. SECTION D4 AND H5 - AS THE DEVICE WAS UNKNOWN BOTH HAVE BEEN PROVIDED: 102316-15. MANUFACTURE DATE: 09NOV2020. EXPIRY DATE: 09NOV2022. OR 102655-49, MANUFACTURE DATE: 03DEC2020, EXPIRY DATE: 03DEC2022.

Additional Manufacturer Narrative · 0

INVESTIGATION OF THIS EVENT IS IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 0

A PATIENT IMPLANTED WITH AN EVOKE SPINAL CORD STIMULATION (SCS) SYSTEM WAS NOT RECEIVING ADEQUATE THERAPY. REPROGRAMMING WAS PERFORMED MULTIPLE TIMES WITHOUT THE DESIRED RESULT. A REVISION SURGERY WAS PERFORMED. DURING THE REVISION PROCEDURE, A DEFORMED NON-ACTIVE BAND WAS NOTED AFTER THE LEAD WAS REMOVED FROM THE CLS. IT IS UNKNOWN WHEN THE DEFORMATION OCCURRED OR WHETHER IT CONTRIBUTED TO THE INADEQUATE THERAPY. FOLLOWING THE PROCEDURE, THE PATIENT WAS RECEIVING ADEQUATE THERAPY.

Description of Event or Problem · 0

A PATIENT IMPLANTED WITH AN EVOKE SPINAL CORD STIMULATION (SCS) SYSTEM WAS NOT RECEIVING ADEQUATE THERAPY. REPROGRAMMING WAS PERFORMED MULTIPLE TIMES WITHOUT THE DESIRED RESULT. A REVISION SURGERY WAS PERFORMED. DURING THE REVISION PROCEDURE, A DEFORMED NON-ACTIVE BAND WAS NOTED AFTER THE LEAD WAS REMOVED FROM THE CLS. IT IS UNKNOWN WHEN THE DEFORMATION OCCURRED OR WHETHER IT CONTRIBUTED TO THE INADEQUATE THERAPY. FOLLOWING THE PROCEDURE, THE PATIENT WAS RECEIVING ADEQUATE THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2136101 EVOKE SCS SYSTEM SCS LEAD LGW SALUDA MEDICAL PTY LTD EVOKE 12C PERCUTANEOUS LEAD KIT - 60CM

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other