FDA Adverse Event Injury Summary report: N

WAVEWRITER ALPHA?

MDR report key: 21867682 · Received April 18, 2025

Report

Report Number
3006630150-2025-02607
Event Type
Injury
Date Received
April 18, 2025
Date of Event
July 26, 2024
Report Date
May 22, 2025
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
LGW
UDI-DI
08714729985099
PMA / PMN Number
P030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

BLOCK B3: APPROXIMATED BASED ON THE DATE THE EXPLANT DATE. ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-EXTENSION. UPN: M365SC3138250. MODEL: SC-3138-25. SERIAL: (B)(6). BATCH: 7073311. PRODUCT FAMILY: SCS-EXTENSION. UPN: M365SC3138250. MODEL: SC-3138-25. SERIAL: (B)(6). BATCH: 7073320. PRODUCT FAMILY: SCS-LINEAR LEADS-MRI. UPN: M365SC2408740. MODEL: SC-2408-74. SERIAL: (B)(6). BATCH: 7078263. PRODUCT FAMILY: SCS-LINEAR LEADS-MRI. UPN: M365SC2408740. MODEL: SC-2408-74. SERIAL: (B)(6). BATCH: 7078392. PRODUCT FAMILY: SCS-LEAD FIXATION-MRI. UPN: M365SC43190. MODEL: SC-4319. SERIAL: N/A. BATCH: 32546212.

Additional Manufacturer Narrative · 0

BLOCK B3: APPROXIMATED BASED ON THE DATE THE MANUFACTURER BECAME AWARE OF THE EVENT. ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-EXTENSION UPN: M365SC3138250 MODEL: SC-3138-25 SERIAL: (B)(6). BATCH: (B)(6). PRODUCT FAMILY: SCS-EXTENSION UPN: M365SC3138250 MODEL: SC-3138-25 SERIAL: (B)(6). BATCH: (B)(6). PRODUCT FAMILY: SCS-LINEAR LEADS-MRI UPN: M365SC2408740 MODEL: SC-2408-74 SERIAL: (B)(6). BATCH: (B)(6). PRODUCT FAMILY: SCS-LINEAR LEADS-MRI UPN: M365SC2408740 MODEL: SC-2408-74 SERIAL: (B)(6). BATCH: (B)(6). PRODUCT FAMILY: SCS-LEAD FIXATION-MRI UPN: M365SC43190 MODEL: SC-4319 SERIAL: N/A BATCH: 32546212.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT EXPERIENCED AN INFECTION AT THE IMPLANTABLE PULSE GENERATOR (IPG) SITE WHICH STARTED AT THE SPINAL CORD STIMULATION (SCS) LEAD ANCHOR FIXATION SITE AND PASSED THROUGH THE TUNNEL AND SPREAD TO THE IPG SITE. THE PATIENT SYMPTOMS INCLUDED PAIN AT THE INFECTED SITE. THE PHYSICIAN ASSESSED THAT THE INFECTION WAS DEVICE RELATED, HOWEVER, ALSO ASSESSED THAT NOTHING HAPPENED DURING THE SCS PROCEDURE THAT MAY HAVE CAUSED OR CONTRIBUTED TO THE INFECTION. A CULTURE WAS TAKEN AND CONFIRMED METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA). DUE TO RENAL FAILURE, STRONG MEDICATION WAS AVOIDED, BUT VANCOMYCIN WAS ADMINISTERED. THE PATIENT UNDERWENT A PROCEDURE WHERE THE SCS SYSTEM WAS EXPLANTED. THE EXPLANTED DEVICES WILL NOT BE RETURNED AS THEY WERE DISCARDED BY THE MEDICAL FACILITY. ADDITIONAL INFORMATION WAS RECEIVED THAT THE WOUND WAS OPENED, DISINFECTED EVERY WEEK AT THE OUTPATIENT CLINIC, AND THEN CLOSED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT EXPERIENCED AN INFECTION AT THE IMPLANTABLE PULSE GENERATOR (IPG) SITE WHICH STARTED AT THE SPINAL CORD STIMULATION (SCS) LEAD ANCHOR FIXATION SITE AND PASSED THROUGH THE TUNNEL AND SPREAD TO THE IPG SITE. THE PATIENT SYMPTOMS INCLUDED PAIN AT THE INFECTED SITE. THE PHYSICIAN ASSESSED THAT THE INFECTION WAS DEVICE RELATED, HOWEVER, ALSO ASSESSED THAT NOTHING HAPPENED DURING THE SCS PROCEDURE THAT MAY HAVE CAUSED OR CONTRIBUTED TO THE INFECTION. A CULTURE WAS TAKEN AND CONFIRMED METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA). DUE TO RENAL FAILURE, STRONG MEDICATION WAS AVOIDED, BUT VANCOMYCIN WAS ADMINISTERED. THE PATIENT UNDERWENT A PROCEDURE WHERE THE SCS SYSTEM WAS EXPLANTED. THE EXPLANTED DEVICES WILL NOT BE RETURNED AS THEY WERE DISCARDED BY THE MEDICAL FACILITY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
32273 WAVEWRITER ALPHA? STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SC-1232 596437 08714729985099

Patients

Seq Age Sex Outcome Treatment
1 30 YR Female Required Intervention