FDA Adverse Event Injury Summary report: N

PRECISION®

MDR report key: 2191970 · Received August 4, 2011

Report

Report Number
3006630150-2011-01138
Event Type
Injury
Date Received
August 4, 2011
Date of Event
June 29, 2011
Report Date
June 29, 2011
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
030017
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

DEVICE ANALYSIS CONFIRMED THE COMPLAINT. THE IPG PASSED ALL THE FUNCTIONAL TESTS, HOWEVER IT EXHIBITED EXCESSIVE BATTERY DEPLETION DUE TO HIGH CURRENT LEAKAGE. THE DEVICE CHARACTERISTICS SEEMS TO HAVE CHANGED JUST PRIOR TO THE IMPLANT. THE SOURCE OF LEAKAGE WAS FOUND TO BE EITHER ANALOG OR DIGITAL IC. TROUBLESHOOTING TO SPECIFIC COMPONENT LEVEL IS IMPOSSIBLE SINCE BOTH ANALOG/DIGITAL ICS ARE COVERED IN THE EPOXY RESIN TOP.

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION RECEIVED INDICATED THAT THE PATIENT HAS DECIDED TO PROCEED WITH AN IPG REVISION.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS HAVING DIFFICULTY CHARGING. A BSN ENGINEER CONFIRMED THAT THE IPG EXHIBITS PREMATURE BATTERY DEPLETION.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS HAVING DIFFICULTY CHARGING. A BSN ENGINEER CONFIRMED THAT THE IPG EXHIBITS PREMATURE BATTERY DEPLETION.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS HAVING DIFFICULTY CHARGING. A BSN ENGINEER CONFIRMED THAT THE IPG EXHIBITS PREMATURE BATTERY DEPLETION.

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