FDA Adverse Event Malfunction Summary report: N

INFINION 16

MDR report key: 19080961 · Received April 10, 2024

Report

Report Number
3006630150-2024-02239
Event Type
Malfunction
Date Received
April 10, 2024
Date of Event
March 20, 2024
Report Date
August 28, 2024
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
UDI-DI
08714729797807
PMA / PMN Number
P030017
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-LINEAR LEADS. UPN: M365SC231650E0. MODEL: SC-2316-50E. SERIAL: (B)(6). BATCH: 7231779.

Additional Manufacturer Narrative · 0

SC-2316-50E ((B)(6)). THE RETURNED LEAD WAS ANALYZED AND VISUAL INSPECTION REVEALED THAT THE TOP SIX ELECTRODES WERE SEPARATED FROM THE DISTAL END AND WERE NOT RETURNED. THE CABLES WERE EXPOSED AT THE DAMAGED PORTION OF THE LEAD. WITH ALL THE AVAILABLE INFORMATION, BOSTON SCIENTIFIC CONCLUDES THAT THE ALLEGATION OF LEAD DAMAGE WAS CONFIRMED. THE FRACTURED CABLES REVEALED FRAYING OF THE BREAKS, LACK OF NECKING AND DISCOLORATION ASSOCIATED WITH WELDING, AND THE PROXIMITY OF THE BREAK POINTS TO THE EDGE OF THE INSULATION INDICATE THAT THE CABLES DID NOT BREAK AT OR NEAR THE WELDS. THESE OBSERVATIONS SUGGEST THAT THERE WERE NO ISSUES DURING THE WELDING PROCESS IN MANUFACTURING. IT APPEARED THAT RESISTANCE WAS FELT DURING THE LEAD PULL AND LEAD WAS SUBJECTED TO EXCESSIVE TENSILE LOAD CAUSING DAMAGE TO THE DISTAL ARRAY. SC-2316-50E ((B)(6)). THE RETURNED LEAD WAS ANALYZED, PASSED ALL TEST PERFORMED, AND EXHIBITED NORMAL DEVICE CHARACTERISTICS.

Additional Manufacturer Narrative · 0

SC-2316-50E (SN: (B)(6)). THE RETURNED LEAD WAS ANALYZED, AND VISUAL INSPECTION REVEALED THAT THE TOP SIX ELECTRODES WERE SEPARATED FROM THE DISTAL END AND WERE NOT RETURNED. THE CABLES WERE EXPOSED AT THE DAMAGED PORTION OF THE LEAD. WITH ALL THE AVAILABLE INFORMATION, BOSTON SCIENTIFIC CONCLUDES THAT THE ALLEGATION OF LEAD DAMAGE WAS CONFIRMED. THE FRACTURED CABLES REVEALED FRAYING OF THE BREAKS, LACK OF NECKING AND DISCOLORATION ASSOCIATED WITH WELDING, AND THE PROXIMITY OF THE BREAK POINTS TO THE EDGE OF THE INSULATION INDICATE THAT THE CABLES DID NOT BREAK AT OR NEAR THE WELDS. THESE OBSERVATIONS SUGGEST THAT THERE WERE NO ISSUES DURING THE WELDING PROCESS IN MANUFACTURING. IT APPEARED THAT RESISTANCE WAS FELT DURING THE LEAD PULL AND LEAD WAS SUBJECTED TO EXCESSIVE TENSILE LOAD CAUSING DAMAGE TO THE DISTAL ARRAY. SC-2316-50E (SN: (B)(6)). THE RETURNED LEAD WAS ANALYZED, PASSED ALL TEST PERFORMED, AND EXHIBITED NORMAL DEVICE CHARACTERISTICS.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING A LEAD PULL PROCEDURE, THE PHYSICIAN NOTICED THAT CONTACTS ON ONE OF THE LEADS WERE SHEARED OFF INTO THE PATIENT. IT WAS NOTED THAT THE CONTACTS WERE LEFT INSIDE THE PATIENTS BODY.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING A LEAD PULL PROCEDURE, THE PHYSICIAN NOTICED THAT CONTACTS ON ONE OF THE LEADS WERE SHEARED OFF INTO THE PATIENT. IT WAS NOTED THAT THE CONTACTS WERE LEFT INSIDE THE PATIENTS BODY. ADDITIONAL INFORMATION WAS RECEIVED THAT THE LEAD CONTACTS LEFT INSIDE THE PATIENTS BODY HAD BEEN REMOVED. THE PATIENT WAS REPORTEDLY DOING WELL AFTER THE PROCEDURE.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING A LEAD PULL PROCEDURE, THE PHYSICIAN NOTICED THAT CONTACTS ON ONE OF THE LEADS WERE SHEARED OFF INTO THE PATIENT. IT WAS NOTED THAT THE CONTACTS WERE LEFT INSIDE THE PATIENTS BODY. ADDITIONAL INFORMATION WAS RECEIVED THAT THE LEAD CONTACTS LEFT INSIDE THE PATIENTS BODY HAD BEEN REMOVED. THE PATIENT WAS REPORTEDLY DOING WELL AFTER THE PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
411952 INFINION 16 STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION SC-2316-50E 7121806 08714729797807

Patients

Seq Age Sex Outcome Treatment
1 75 YR Male Required Intervention| O