FDA Adverse Event Injury Summary report: N

PRECISION? MONTAGE? MRI

MDR report key: 21776914 · Received April 4, 2025

Report

Report Number
3006630150-2025-02172
Event Type
Injury
Date Received
April 4, 2025
Date of Event
March 14, 2025
Report Date
April 4, 2025
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
LGW
UDI-DI
08714729905943
PMA / PMN Number
P030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
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-MRI, UPN: M365SC2408740, MODEL: SC-2408-74, SERIAL: (B)(6), BATCH: 21043969, UDI: (B)(4). ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-LINEAR LEADS-MRI, UPN: M365SC2408560, MODEL: SC-2408-56, SERIAL: (B)(6), BATCH: 5022325, UDI: (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT PATIENT WAS NOT ABLE TO GET ENOUGH PAIN RELIEF FROM THE SPINAL CORD STIMULATOR (SCS) DEVICES. THE PATIENT UNDERWENT A SPINAL CORD STIMULATOR (SCS) EXPLANT PROCEDURE WHERE ALL DEVICES WERE REMOVED. NO FURTHER INFORMATION WAS OBTAINED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
786085 PRECISION? MONTAGE? MRI STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SC-1200 350278 08714729905943

Patients

Seq Age Sex Outcome Treatment
1 76 YR Female Required Intervention