FDA Adverse Event Injury Summary report: N

LINEAR ST

MDR report key: 20348904 · Received October 1, 2024

Report

Report Number
3006630150-2024-06545
Event Type
Injury
Date Received
October 1, 2024
Date of Event
June 26, 2024
Report Date
October 1, 2024
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
UDI-DI
08714729767725
PMA / PMN Number
P030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

APPROXIMATED BASED ON THE DATE THE MANUFACTURER BECAME AWARE OF THE EVENT. ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-LINEAR LEADS UPN: M365SC2218500 MODEL: SC-2218-50 SERIAL: (B)(6) BATCH: 7124061.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE LEADS MIGRATED WHICH WAS CONFIRMED THROUGH X-RAY. THE PATIENT UNDERWENT A REVISION PROCEDURE WHEREIN THE LEADS WERE PUT BACK AND FIXED WITH CLIK ANCHORS. THE PATIENT WAS DOING WELL POSTOPERATIVELY AND COVERAGE WAS REGAINED. THE LEADS REMAIN IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2352091 LINEAR ST STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION SC-2218-50 7133402 08714729767725

Patients

Seq Age Sex Outcome Treatment
1 54 YR Female Required Intervention