FDA Adverse Event Injury Summary report: N

LAMITRODE 88 PADDLE LEAD

MDR report key: 1870962 · Received October 8, 2010

Report

Report Number
1627487-2010-02798
Event Type
Injury
Date Received
October 8, 2010
Date of Event
August 19, 2010
Report Date
September 10, 2010
Manufacturer
ADVANCED NEUROMODULATION SYSTEMS, INC.
Product Code
LGW
PMA / PMN Number
P010032
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

EVALUATION: THE REPORTED INFECTION CAN NOT BE CONFIRMED THROUGH TESTING. METHOD: THE DEVICE HISTORY AND STERILIZATION RECORDS WERE ALSO REVIEWED. RESULTS: THE DEVICE HISTORY AND STERILIZATION RECORDS WERE REVIEWED AND WERE FOUND TO MEET SPECIFICATIONS AND NO ANOMALIES WERE FOUND. CONCLUSION: THE CAUSE OF THE INFECTION COULD NOT BE DETERMINED FROM THE REVIEW OF THE DHR AND STERILIZATION RECORDS. ANS HAS LIMITED INFORMATION RELATED TO THE PATIENT'S MEDICAL HISTORY AND IS UNABLE TO FORM AN OPINION AS TO THE RELEVANCY OF THE PATIENT'S HISTORY TO THE EVENT REPORTED. ANS DEFERS TO THE PATIENT'S PHYSICIAN REGARDING MEDICAL HISTORY.

Description of Event or Problem · 1

ON (B)(6) 2010, THE PATIENT WAS IMPLANTED WITH AN SCS SYSTEM. ON (B)(6) 2010, IT WAS REPORTED THAT THE PATIENT'S SYSTEM WOULD BE EXPLANTED ON (B)(6) 2010 DUE TO AN INFECTION AT THE LEAD INCISION SITE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LAMITRODE 88 PADDLE LEAD SPINAL CORD STIMULATION LEAD LGW ADVANCED NEUROMODULATION SYSTEMS, INC. 3288 2886921

Patients

Seq Age Sex Outcome Treatment
1 Other