FDA Adverse Event Injury Summary report: N

PRECISION®

MDR report key: 2110587 · Received June 1, 2011

Report

Report Number
3006630150-2011-00770
Event Type
Injury
Date Received
June 1, 2011
Report Date
April 22, 2011
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(6).

Additional Manufacturer Narrative · 1

A RETURNED PRODUCT ANALYSIS INDICATED THAT THE DEVICE PASSED ALL VISUAL, ELECTRICAL, PERFORMANCE AND PHOTOGRAPHIC IMAGING TESTS PERFORMED. THE DEVICE EXHIBITS NORMAL DEVICE CHARACTERISTICS.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS EXPERIENCING INTERMITTENT AND PAINFUL SENSATION OF HEAT AT THE IPG SITE WHICH BEGAN FOLLOWING A SPINAL FUSION PROCEDURE PERFORMED IN (B)(6) 2010. A BSN ENGINEER ANALYZED THE PATIENT'S DATABASE AND FOUND NO ANOMALIES. THE IPG TEMPERATURE HISTORY WAS HIGHER THAN GENERALLY OBSERVED, BUT WITHIN DEVICE LIMITS. THIS INCREASE MAY BE RELATED TO CHARGING TECHNIQUE. THE PHYSICIAN DECIDED TO REPLACE THE PATIENT'S IPG AND THE PATIENT IS DOING WELL FOLLOWING THE PROCEDURE.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS EXPERIENCING INTERMITTENT AND PAINFUL SENSATION OF HEAT AT THE IPG SITE WHICH BEGAN FOLLOWING A SPINAL FUSION PROCEDURE PERFORMED IN (B)(6) 2010. A BSN ENGINEER ANALYZED THE PATIENT'S DATABASE AND FOUND NO ANOMALIES. THE IPG TEMPERATURE HISTORY WAS HIGHER THAN GENERALLY OBSERVED, BUT WITHIN DEVICE LIMITS. THIS INCREASE MAY BE RELATED TO CHARGING TECHNIQUE. THE PHYSICIAN DECIDED TO REPLACE THE PATIENT'S IPG AND THE PATIENT IS DOING WELL FOLLOWING THE PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PRECISION® SPINAL CORD STIMULATOR LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1110 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention