FDA Adverse Event Injury Summary report: N

PRECISION MONTAGE MRI

MDR report key: 20365408 · Received October 4, 2024

Report

Report Number
3006630150-2024-06638
Event Type
Injury
Date Received
October 4, 2024
Date of Event
November 1, 2021
Report Date
November 26, 2024
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
LGW
UDI-DI
08714729905943
PMA / PMN Number
P030017
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: BRAND NAME: LINEAR 3-6, UPN: M365SC2366500, MODEL: SC-2366-50, SERIAL: (B)(6), BATCH: 7072560.

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: BRAND NAME: LINEAR 3-6. UPN: M365SC2366500. MODEL: SC-2366-50. SERIAL/BATCH: (B)(6). THE DEVICES WERE RETURNED, ANALYZED, PASSED ALL TESTS PERFORMED, AND EXHIBITED NORMAL DEVICE CHARACTERISTICS. A LABELING REVIEW WAS PERFORMED ON THE IMPLANTABLE PULSE GENERATOR, IPG, AND LEADS INSTRUCTIONS FOR USE, IFU. THERE WAS NO EVIDENCE THAT THE DEVICE WAS USED IN A MANNER INCONSISTENT WITH THE LABELED INDICATIONS. IT STATES THAT THE POSSIBLE RISKS OF IMPLANTING A PULSE GENERATOR AS PART OF A SYSTEM TO DELIVER SPINAL CORD STIMULATION INCLUDE SKIN EROSION AT THE IPG SITE CAN OCCUR OVER TIME. UNDESIRABLE STIMULATION MAY OCCUR OVER TIME DUE TO CELLULAR CHANGES IN TISSUE AROUND THE ELECTRODES, CHANGES IN ELECTRODE POSITION, LOOSE ELECTRICAL CONNECTIONS AND/OR LEAD FAILURE. LEAD MIGRATION, RESULTING IN UNDESIRABLE CHANGES IN STIMULATION AND SUBSEQUENT REDUCTION IN PAIN RELIEF. SYSTEM FAILURE, WHICH CAN OCCUR AT ANY TIME DUE TO RANDOM FAILURE(S) OF THE COMPONENTS OR THE BATTERY. THESE EVENTS, WHICH MAY INCLUDE DEVICE FAILURE, LEAD BREAKAGE, HARDWARE MALFUNCTIONS, LOOSE CONNECTIONS, ELECTRICAL SHORTS OR OPEN CIRCUITS AND LEAD INSULATION BREACHES, CAN RESULT IN INEFFECTIVE PAIN CONTROL. BASED ON ALL AVAILABLE INFORMATION, ENGINEERS ARE ABLE TO CONFIRM THE ROOT CAUSE OF THE EVENT. THE DEVICES WERE RETURNED AS SUCH PHYSICAL ANALYSIS WAS CONDUCTED, RECORD REVIEW REVEALED NO ADDITIONAL INFORMATION RELATED TO THE COMPLAINT. THEREFORE, THIS INVESTIGATION IS ABLE TO DETERMINE A PROBABLE ROOT CAUSE FOR THE COMPLAINT AS KNOWN INHERENT RISK OF DEVICE.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT EXPERIENCED INADEQUATE STIMULATION FROM THE SPINAL CORD STIMULATOR (SCS) SYSTEM. THE PATIENT REPORTED THAT POST IMPLANT THE THERAPY WAS ADEQUATE BUT SOMETHING HAPPENED, BUT SHE DID NOT SPECIFY WHAT, AND HENCE TURNED THE STIMULATION OFF FOR TWO YEARS, SHE ALSO REPORTED PAIN AND PROTRUSION OF THE IMPLANTABLE PULSE GENERATOR (IPG). FURTHER REVIEW DETERMINED THAT THE PATIENTS' PERIPHERAL LEAD MIGRATED, ALTHOUGH IMAGING WAS NOT AVAILABLE TO CONFIRM, CONTRIBUTING TO INADEQUATE STIMULATION. THE PATIENT UNDERWENT A PROCEDURE IN WHICH THE IPG AND THE LEAD WERE EXPLANTED, THE PATIENT IS DOING WELL POST OPERATIVELY.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT EXPERIENCED INADEQUATE STIMULATION FROM THE SPINAL CORD STIMULATOR (SCS) SYSTEM. THE PATIENT REPORTED THAT POST IMPLANT THE THERAPY WAS ADEQUATE BUT SOMETHING HAPPENED, BUT SHE DID NOT SPECIFY WHAT, AND HENCE TURNED THE STIMULATION OFF FOR TWO YEARS, SHE ALSO REPORTED PAIN AND PROTRUSION OF THE IMPLANTABLE PULSE GENERATOR (IPG). FURTHER REVIEW DETERMINED THAT THE PATIENTS' PERIPHERAL LEAD MIGRATED, ALTHOUGH IMAGING WAS NOT AVAILABLE TO CONFIRM, CONTRIBUTING TO INADEQUATE STIMULATION. THE PATIENT UNDERWENT A PROCEDURE IN WHICH THE IPG AND THE LEAD WERE EXPLANTED, THE PATIENT IS DOING WELL POST OPERATIVELY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1325709 PRECISION MONTAGE MRI STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SC-1200 373749 08714729905943

Patients

Seq Age Sex Outcome Treatment
1 49 YR Female Required Intervention