FDA Adverse Event Injury Summary report: N

LINEAR ST

MDR report key: 21006811 · Received December 23, 2024

Report

Report Number
3006630150-2024-08959
Event Type
Injury
Date Received
December 23, 2024
Date of Event
July 29, 2024
Report Date
December 23, 2024
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
LGW
PMA / PMN Number
P030017
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

BLOCK B3: 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) AND BATCH: 7123384.

Description of Event or Problem · 0

IT WAS REPORTED THAT PATIENTS SPINAL CORD STIMULATOR LEAD HAD IMPEDANCES. IT WAS NOTED THAT PATIENT WAS NOT ABLE TO GET ENOUGH PAIN RELIEF. THE PATIENT UNDERWENT A SPINAL CORD STIMULATOR LEAD REPLACEMENT PROCEDURE AND WAS DOING WELL POST OPERATIVELY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
54938 LINEAR ST STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SC-2218-50 7124916

Patients

Seq Age Sex Outcome Treatment
1 52 YR Female Required Intervention