FDA Adverse Event Injury Summary report: N

PRECISION®

MDR report key: 2181229 · Received July 27, 2011

Report

Report Number
3006630150-2011-01186
Event Type
Injury
Date Received
July 27, 2011
Report Date
July 6, 2011
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

A REVIEW OF THE MANUFACTURING DOCUMENTATION OF THE PADDLE LEAD REVEALED NO ANOMALIES OR DEVIATIONS POTENTIALLY RELATED TO THE REPORTED EVENT OCCURRED DURING MANUFACTURING. A REVIEW OF THE STERILIZATION DOCUMENTATION FOUND THEM TO BE SATISFACTORY.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT HAD DRAINAGE FROM THE LEAD SITE AND WAS PRESCRIBED ANTIBIOTICS. NO CULTURES WERE TAKEN. THE PHYSICIAN BELIEVES THAT THE INFECTION IS NOT DEVICE RELATED. THE PATIENT HAS SINCE HEALED AND DOING WELL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PRECISION® SPINAL CORD STIMULATOR LGW BOSTON SCIENTIFIC NEUROMODULATION SC-8216-70 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention