FDA Adverse Event
Injury
Summary report: N
PRECISION®
MDR report key: 2171755
·
Received July 22, 2011
Report
- Report Number
- 3006630150-2011-01099
- Event Type
- Injury
- Date Received
- July 22, 2011
- Date of Event
- June 22, 2011
- Report Date
- June 22, 2011
- Manufacturer
- BOSTON SCIENTIFIC NEUROMODULATION
- Product Code
- LGW
- PMA / PMN Number
- 030017
- Removal / Correction Number
- NA
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TX, US
- Reporter Occupation
- HEALTH PROFESSIONAL
Narratives
Description of Event or Problem · 1
A REPORT WAS RECEIVED THAT A PATIENT UNDERWENT A POCKET REVISION DUE TO DISCOMFORT. THE PHYSICIAN REVISED THE PATIENT'S POCKET SITE TO A MORE COMFORTABLE LOCATION. NOTHING WAS IMPLANTED OR EXPLANTED AND THE PATIENT IS REPORTEDLY DOING WELL.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | PRECISION® | SPINAL CORD STIMULATOR | LGW | BOSTON SCIENTIFIC NEUROMODULATION | SC-1110-02 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 44 YR | Required Intervention |