FDA Adverse Event Injury Summary report: N

VERCISE CARTESIA

MDR report key: 21063353 · Received January 2, 2025

Report

Report Number
3006630150-2024-09242
Event Type
Injury
Date Received
January 2, 2025
Date of Event
November 20, 2024
Report Date
January 2, 2025
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
MHY
UDI-DI
08714729905288
PMA / PMN Number
P150031
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

ADDITIONAL PRO CODE SELECTION THAT APPLIES TO THE INDICATION OF THIS DEVICE - NHL. ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT: PRODUCT FAMILY: DBS-LINEAR LEADS UPN: M365DB2202450 MODEL: DB-2202-45 SERIAL: (B)(6) BATCH: 7079703. PRODUCT FAMILY: DBS-IPG-R-MRI UPN: M365DB1200S0 MODEL: DB-1200-S SERIAL: (B)(6) BATCH: 744976. PRODUCT FAMILY: DBS-EXTENSION UPN: M365NM3138550 MODEL: NM-3138-55 SERIAL: (B)(6) BATCH: 7082581. PRODUCT FAMILY: DBS-EXTENSION UPN: M365NM3138550 MODEL: NM-3138-55 SERIAL: (B)(6) BATCH: 7083183. PRODUCT FAMILY: DBS-LEAD FIXATION UPN: M365DB4600C0 MODEL: DB-4600-C SERIAL: NULL BATCH: 26210178.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE DEEP BRAIN STIMULATION (DBS) PATIENT EXPERIENCED AN INFECTION IN THE HEAD AREA WHEREIN THERE WAS A PRESENCE OF PUSS AT THE SITE. THE PATIENT ALSO EXPERIENCED SYMPTOMS OF A FEVER. THE PATIENT UNDERWENT AN EXPLANT PROCEDURE WHERE THE FULL DBS SYSTEM WAS REMOVED. THE PATIENT WAS ADMINISTERED ANTIBIOTICS. THE PATIENT WAS DOING WELL POST-OPERATIVELY. THE EXPLANTED DEVICES WERE RETAINED BY THE MEDICAL FACILITY AND WERE NOT RETURNED TO BSC.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
638855 VERCISE CARTESIA STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN TREMOR MHY BOSTON SCIENTIFIC NEUROMODULATION CORPORATION DB-2202-45 7079369 08714729905288

Patients

Seq Age Sex Outcome Treatment
1 84 YR Male Required Intervention