FDA Adverse Event Injury Summary report: N

PRECISION®

MDR report key: 2180213 · Received July 27, 2011

Report

Report Number
3006630150-2011-01119
Event Type
Injury
Date Received
July 27, 2011
Date of Event
April 20, 2011
Report Date
April 20, 2011
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE RETURNED IPG PASSED VISUAL, ELECTRICAL, PERFORMANCE, AND PHOTOGRAPHIC INSPECTION TESTS. THE FAILURE ANALYSIS COULD NOT DETERMINE THE PROGRAMMED STIMULATION CAUSED THE REPORTED PRESSURE/PAIN AT THE IPG SITE. AS THE COMPLAINT ITSELF IS SUBJECTIVE, THE FAILURE ANALYSIS WAS TO VERIFY WHETHER THE DEVICE IS GENERATING UNREGULATED STIMULATIONS. TWO CONCURRENT STIMULATIONS, "FONT LEG" AND "BACK LEG" WERE RUNNING CONCURRENTLY WHEN THE LATEST SETTING WAS ACTIVATED. WHILE THE OUTPUTS WERE MONITORED ON A SCOPE, THE AMPLITUDE AND PULSE WIDTH OF THE SETTING WERE MEASURED AND VERIFIED TO BE CORRECT ON ALL ELECTRODES. THE SEEPROM DATA WAS EXAMINED, AND NO ANOMALIES WERE FOUND. THE DC/CURRENT LEAKAGE TESTS VERIFIED THAT THE DEVICE DOES NOT ALLURE THE SURROUNDING MASS. THE DEVICE EXHIBITED NORMAL DEVICE CHARACTERISTICS.

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION WAS RECEIVED THAT THE PATIENT'S IPG WAS REPLACED AND RELOCATED DUE TO PAIN AT THE POCKET SITE. THE PATIENT WAS REPORTEDLY DOING WELL FOLLOWING THE PROCEDURE.

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION WAS RECEIVED THAT NO FURTHER ACTION WILL BE TAKEN AT THIS TIME. A REVIEW OF THE MANUFACTURING DOCUMENTATION FOR THE IPG REVEALED THAT NO ANOMALIES OR DEVIATIONS POTENTIALLY RELATED TO THE EVENT OCCURRED DURING MANUFACTURING. A REVIEW OF THE STERILIZATION DOCUMENTATION FOR THE IPG FOUND THEM TO BE SATISFACTORY.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS EXPERIENCING PAIN, SENSITIVITY AND BURNING AT THE POCKET SITE. THE PHYSICIAN DETERMINED THAT THE POCKET WAS NORMAL. THE PATIENT WAS GIVEN NEW PROGRAMS, BUT THE ISSUE WAS NOT RESOLVED. THE IPG DATABASE ANALYSIS CONFIRMED THE DEVICE WAS WORKING PROPERLY. THE PHYSICIAN PRESCRIBED LIDOCAINE PATCHES FOR THE PATIENT TO APPLY TO THE POCKET SITE, BUT THE PATIENT DID NOT NOTICE A REDUCTION IN PAIN. THE PHYSICIAN HAS RECOMMENDED A POCKET REVISION.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS EXPERIENCING PAIN, SENSITIVITY AND BURNING AT THE POCKET SITE. THE PHYSICIAN DETERMINED THAT THE POCKET WAS NORMAL. THE PATIENT WAS GIVEN NEW PROGRAMS, BUT THE ISSUE WAS NOT RESOLVED. THE IPG DATABASE ANALYSIS CONFIRMED THE DEVICE WAS WORKING PROPERLY. THE PHYSICIAN PRESCRIBED LIDOCAINE PATCHES FOR THE PATIENT TO APPLY TO THE POCKET SITE, BUT THE PATIENT DID NOT NOTICE A REDUCTION IN PAIN. THE PHYSICIAN HAS RECOMMENDED A POCKET REVISION.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS EXPERIENCING PAIN, SENSITIVITY AND BURNING AT THE POCKET SITE. THE PHYSICIAN DETERMINED THAT THE POCKET WAS NORMAL. THE PATIENT WAS GIVEN NEW PROGRAMS, BUT THE ISSUE WAS NOT RESOLVED. THE IPG DATABASE ANALYSIS CONFIRMED THE DEVICE WAS WORKING PROPERLY. THE PHYSICIAN PRESCRIBED LIDOCAINE PATCHES FOR THE PATIENT TO APPLY TO THE POCKET SITE, BUT THE PATIENT DID NOT NOTICE A REDUCTION IN PAIN. THE PHYSICIAN HAS RECOMMENDED A POCKET REVISION.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS EXPERIENCING PAIN, SENSITIVITY AND BURNING AT THE POCKET SITE. THE PHYSICIAN DETERMINED THAT THE POCKET WAS NORMAL. THE PATIENT WAS GIVEN NEW PROGRAMS, BUT THE ISSUE WAS NOT RESOLVED. THE IPG DATABASE ANALYSIS CONFIRMED THE DEVICE WAS WORKING PROPERLY. THE PHYSICIAN PRESCRIBED LIDOCAINE PATCHES FOR THE PATIENT TO APPLY TO THE POCKET SITE, BUT THE PATIENT DID NOT NOTICE A REDUCTION IN PAIN. THE PHYSICIAN HAS RECOMMENDED A POCKET REVISION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PRECISION® SPINAL CORD STIMULATOR LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1110-02 N/A

Patients

Seq Age Sex Outcome Treatment
1 30 YR Required Intervention