FDA Adverse Event Injury Summary report: N

LINEAR ST

MDR report key: 19175874 · Received April 24, 2024

Report

Report Number
3006630150-2024-02598
Event Type
Injury
Date Received
April 24, 2024
Date of Event
March 30, 2024
Report Date
September 22, 2024
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
UDI-DI
08714729767725
PMA / PMN Number
P030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-IPG-PC. UPN: M365SC14160. MODEL: SC-1416. SERIAL: (B)(6). BATCH: 222854.

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-LINEAR LEADS. UPN: M365SC2218500. MODEL: SC-2218-50. SERIAL: (B)(6). BATCH: 7141019.

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-IPG-PC. UPN: M365SC14160. MODEL: SC-1416. SERIAL: (B)(6). BATCH: 222854.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT WAS EXPERIENCING SEVERE PAIN AND WEAKNESS IN THE LEGS FOLLOWING AN IMPLANT PROCEDURE. THE PATIENT WENT TO THE EMERGENCY ROOM (ER) AND WAS ADMITTED TO THE HOSPITAL. A MAGNETIC RESONANCE IMAGING (MRI) WAS DONE, AND HEMATOMA WAS CONFIRMED. THE PHYSICIAN BELIEVED THAT THE HEMATOMA WAS NOT DEVICE OR PROCEDURE RELATED. THE PATIENT UNDERWENT AN EXPLANT PROCEDURE, AND ALL DEVICE COMPONENTS WERE REMOVED AND DISCARDED BY THE MEDICAL FACILITY.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT WAS EXPERIENCING SEVERE PAIN AND WEAKNESS IN THE LEGS FOLLOWING AN IMPLANT PROCEDURE. THE PATIENT WENT TO THE EMERGENCY ROOM (ER) AND WAS ADMITTED TO THE HOSPITAL. A MAGNETIC RESONANCE IMAGING (MRI) WAS DONE, AND HEMATOMA WAS CONFIRMED. THE PHYSICIAN BELIEVED THAT THE HEMATOMA WAS NOT DEVICE OR PROCEDURE RELATED. THE PATIENT UNDERWENT AN EXPLANT PROCEDURE, AND ALL DEVICE COMPONENTS WERE REMOVED AND DISCARDED BY THE MEDICAL FACILITY.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT WAS EXPERIENCING SEVERE PAIN AND WEAKNESS IN THE LEGS FOLLOWING AN IMPLANT PROCEDURE. THE PATIENT WENT TO THE EMERGENCY ROOM (ER) AND WAS ADMITTED TO THE HOSPITAL. A MAGNETIC RESONANCE IMAGING (MRI) WAS DONE, AND HEMATOMA WAS CONFIRMED. THE PHYSICIAN BELIEVED THAT THE HEMATOMA WAS NOT DEVICE OR PROCEDURE RELATED. THE PATIENT UNDERWENT AN EXPLANT PROCEDURE, AND ALL DEVICE COMPONENTS WERE REMOVED AND DISCARDED BY THE MEDICAL FACILITY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1427625 LINEAR ST STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION SC-2218-50 7139840 08714729767725

Patients

Seq Age Sex Outcome Treatment
1 82 YR Male Required Intervention