FDA Adverse Event Injury Summary report: N

PRECISION®

MDR report key: 2003973 · Received March 1, 2011

Report

Report Number
3006630150-2011-00278
Event Type
Injury
Date Received
March 1, 2011
Date of Event
January 24, 2011
Report Date
January 24, 2011
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
P030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE EXPLANTED IPG PASSED VISUAL, PHOTOGRAPHIC IMAGING, ELECTRICAL AND PERFORMANCE TESTS PERFORMED. THE DEVICE EXHIBITS NORMAL DEVICE CHARACTERISTICS.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT IS EXPERIENCING CHARGING DIFFICULTY. THE PATIENT'S IPG IS IMPLANTED TOO DEEPLY. THE PATIENT IS SCHEDULED TO UNDERGO A POCKET REVISION.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT IS EXPERIENCING CHARGING DIFFICULTY. THE PATIENT'S IPG IS IMPLANTED TOO DEEPLY. THE PATIENT IS SCHEDULED TO UNDERGO A POCKET REVISION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PRECISION® SPINAL CORD STIMULATOR LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1110-02 NA

Patients

Seq Age Sex Outcome Treatment
1 33 YR Required Intervention