FDA Adverse Event Injury Summary report: N

WAVEWRITER ALPHA?

MDR report key: 20865482 · Received December 6, 2024

Report

Report Number
3006630150-2024-08492
Event Type
Injury
Date Received
December 6, 2024
Date of Event
November 9, 2024
Report Date
May 29, 2026
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
LGW
UDI-DI
08714729985099
PMA / PMN Number
P030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

BLOCK B3: EXACT DATE UNKNOWN, EVENT OCCURRED FIVE DAYS PRIOR FROM THE DATE MANUFACTURER BECAME AWARE OF THE EVENT. ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-LINEAR LEADS. UPN: M365SC2318700. MODEL: SC-2318-70. SERIAL: (B)(6). BATCH: 5001303. UDI: (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT HAD WOUND OVER THE IMPLANTABLE PULSE GENERATOR (IPG) SITE THAT WAS NOT HEALING FOLLOWING THE REVISION PROCEDURE (MFR. 3006630150-2024-07521). THE PATIENT WAS SENT FOR WOUND CARE AND WAS GIVEN ANTIBIOTICS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT HAD WOUND OVER THE IMPLANTABLE PULSE GENERATOR (IPG) SITE THAT WAS NOT HEALING FOLLOWING THE REVISION PROCEDURE (MFR. 3006630150-2024-07521). THE PATIENT WAS SENT FOR WOUND CARE AND WAS GIVEN ANTIBIOTICS. ADDITIONAL INFORMATION WAS RECEIVED THAT ALL DEVICE COMPONENTS WERE EXPLANTED AND DISCARDED BY THE MEDICAL FACILITY. NO FURTHER INFORMATION HAS BEEN OBTAINED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
354129 WAVEWRITER ALPHA? STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SC-1232 761666 08714729985099

Patients

Seq Age Sex Outcome Treatment
1