FDA Adverse Event Injury Summary report: N

REACTIV8

MDR report key: 20163361 · Received September 6, 2024

Report

Report Number
3013017877-2024-00064
Event Type
Injury
Date Received
September 6, 2024
Date of Event
December 11, 2023
Report Date
December 19, 2024
Manufacturer
MAINSTAY MEDICAL LIMITED
Product Code
QLK
PMA / PMN Number
P190021
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

MML REFERENCE #: (B)(4). OTHER DEVICES EXPLANTED: MODEL: 8145, DESCRIPTION: REACTIV8 IMPLANTABLE STIMULATION LEADS, SERIAL NUMBERS: (B)(6), UDI: (B)(4). THE DEVICES WERE RECEIVED AND EVALUATED. THERE WAS NO ALLEGATION AGAINST THE FUNCTIONALITY OF THE EXPLANTED DEVICES. THE IPG PASSED THE FUNCTIONAL TESTING AND OPERATED WITHIN THE MANUFACTURING SPECIFICATIONS A VISUAL INSPECTION WAS CARRIED OUT ON THE IPG. NO ANOMALIES OR OBSERVATIONS WERE IDENTIFIED. NO FUNCTIONAL TESTING COULD BE DONE ON THE LEADS BECAUSE THEY WERE DAMAGED FROM THE EXPLANT. THE MANUFACTURING RECORDS FOR THE IPG AND LEADS WERE REVIEWED, AND NO RELEVANT NONCONFORMANCES WERE FOUND.

Additional Manufacturer Narrative · 0

MML REFERENCE (B)(4). OTHER DEVICES EXPLANTED: MODEL: 8145. DESCRIPTION: STIMULATION LEAD: SERIAL NUMBERS: (B)(6), UDI:(B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT EXPERIENCED DISCOMFORT ON THE IMPLANTABLE PULSE GENERATOR (IPG) POCKET SITE AND WANTS THE DEVICE REMOVED. REPORTEDLY, THE PATIENT HAS INCREASING NEUROPATHIC PAIN BILATERAL TO LOWER LIMBS AND LEGS NOT ASSOCIATED WITH THE IMPLANTED DEVICE AND WANTS THE DEVICE REMOVED TO SEEK OTHER OPTIONS FOR NEUROPATHIC PAIN. THE DEVICE WAS REMOVED. HOWEVER, THE SURGEON PROCEEDED WITH MANUAL EXTRACTION THAN THE TOOL TO EXPLANT THE LEADS, AND THEREFORE, THE DISTAL ELECTRODE ON THE RIGHT LEAD AND SOME LEAD FRAGMENTS WERE LEFT IN THE PATIENT. THERE WAS NO REPORT OF PATIENT HARM OR INJURY.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT EXPERIENCED DISCOMFORT ON THE IMPLANTABLE PULSE GENERATOR (IPG) POCKET SITE AND WANTS THE DEVICE REMOVED. REPORTEDLY, THE PATIENT HAS INCREASING NEUROPATHIC PAIN BILATERAL TO LOWER LIMBS AND LEGS NOT ASSOCIATED WITH THE IMPLANTED DEVICE AND WANTS THE DEVICE REMOVED TO SEEK OTHER OPTIONS FOR NEUROPATHIC PAIN. THE DEVICE WAS REMOVED. HOWEVER, THE SURGEON PROCEEDED WITH MANUAL EXTRACTION THAN THE TOOL TO EXPLANT THE LEADS, AND THEREFORE, THE DISTAL ELECTRODE ON THE RIGHT LEAD AND SOME LEAD FRAGMENTS WERE LEFT IN THE PATIENT. THERE WAS NO REPORT OF PATIENT HARM OR INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1346500 REACTIV8 REACTIV8 IMPLANTABLE PULSE GENERATOR QLK MAINSTAY MEDICAL LIMITED 5100

Patients

Seq Age Sex Outcome Treatment
1 20 YR Male Other