FDA Adverse Event Injury Summary report: N

WAVEWRITER ALPHA?

MDR report key: 20240464 · Received September 17, 2024

Report

Report Number
3006630150-2024-06179
Event Type
Injury
Date Received
September 17, 2024
Date of Event
December 1, 2022
Report Date
April 28, 2026
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
LGW
UDI-DI
08714729985099
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AR, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-PADDLE LEADS. UPN: M365SC8336500. MODEL: SC-8336-50. SERIAL: (B)(6). BATCH: 7082128.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT HAD INADEQUATE PAIN RELIEF DESPITE MULTIPLE REPROGRAMMING. THE PATIENT UNDERWENT AN EXPLANT PROCEDURE WHEREIN ALL DEVICE COMPONENTS WERE REMOVED AND NOT RETURNED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
414902 WAVEWRITER ALPHA? STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SC-1232 554322 08714729985099

Patients

Seq Age Sex Outcome Treatment
1