FDA Adverse Event Injury Summary report: N

VERCISE GENUS?

MDR report key: 21965105 · Received May 5, 2025

Report

Report Number
3006630150-2025-03070
Event Type
Injury
Date Received
May 5, 2025
Date of Event
April 18, 2024
Report Date
April 8, 2026
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
NHL
UDI-DI
08714729985020
PMA / PMN Number
P150031
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

CORRECTIONS TO INITIAL REPORT IN FIELD: H11. ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: PRODUCT FAMILY: DBS-LINEAR LEADS. UPN: M365DB2202450. MODEL: DB-2202-45. SERIAL: (B)(6). BATCH: 7092442. PRODUCT FAMILY: DBS-LINEAR LEADS. UPN: M365DB2202450. MODEL: DB-2202-45. SERIAL: (B)(6). BATCH: 7092710. PRODUCT FAMILY: DBS-EXTENSION. UPN: M365NM3138550. MODEL: NM-3138-55. SERIAL: (B)(6). BATCH: 7100064. PRODUCT FAMILY: DBS-EXTENSION. UPN: M365NM3138550. MODEL: NM-3138-55. SERIAL: (B)(6). BATCH: 7100027. PRODUCT FAMILY: DBS-LEAD FIXATION. UPN: M365DB4600C0. MODEL: DB-4600-C. BATCH: 29406372.

Additional Manufacturer Narrative · 0

CORRECTION TO INITIAL REPORT IN BLOCK: H11. BLOCK D2B; ADDITIONAL APPLICABLE PRODUCT CODES: MHY, PJS ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: PRODUCT FAMILY: DBS-LINEAR LEADS UPN: M365DB2202450 MODEL: DB-2202-45 SERIAL: (B)(6) BATCH: 7092442 PRODUCT FAMILY: DBS-LINEAR LEADS UPN: M365DB2202450 MODEL: DB-2202-45 SERIAL: (B)(6) BATCH: 7092710 PRODUCT FAMILY: DBS-EXTENSION UPN: M365NM3138550 MODEL: NM-3138-55 SERIAL: (B)(6). BATCH: 7100064 PRODUCT FAMILY: DBS-EXTENSION UPN: M365NM3138550 MODEL: NM-3138-55 SERIAL:(B)(6) BATCH: 7100027 PRODUCT FAMILY: DBS-LEAD FIXATION UPN: M365DB4600C0 MODEL: DB-4600-C BATCH: 29406372 THE DEVICES WERE NOT RETURNED FOR ANALYSIS; THEREFORE, A TECHNICAL ANALYSIS COULD NOT BE PERFORMED. BASED ON A THOROUGH REVIEW OF THE REPORTED COMPLAINTS, BOSTON SCIENTIFIC HAS ASSIGNED AN INVESTIGATION CONCLUSION CODE OF KNOWN INHERENT RISK OF DEVICE.

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: PRODUCT FAMILY: DBS-LINEAR LEADS UPN: M365DB2202450 MODEL: DB-2202-45 SERIAL: (B)(6). BATCH: 7092442 PRODUCT FAMILY: DBS-LINEAR LEADS UPN: M365DB2202450 MODEL: DB-2202-45 SERIAL: (B)(6). BATCH: 7092710 PRODUCT FAMILY: DBS-EXTENSION UPN: M365NM3138550 MODEL: NM-3138-55 SERIAL: (B)(6). BATCH: 7100064 PRODUCT FAMILY: DBS-EXTENSION UPN: M365NM3138550 MODEL: NM-3138-55 SERIAL: (B)(6). BATCH: 7100027 PRODUCT FAMILY: DBS-LEAD FIXATION UPN: M365DB4600C0 MODEL: DB-4600-C BATCH: 29406372.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE DEEP BRAIN STIMULATION (DBS) PATIENT SUFFERED A HEAD INJURY AT THE LEAD AND LEAD EXTENSION CONNECTION SITE, RESULTING IN EXPOSURE OF THE DEVICE AT THE CONNECTION POINT AND SUBSEQUENT INFECTION. A CULTURE WAS TAKEN, BUT THE RESULTS ARE UNKNOWN. THE PATIENT WAS TREATED WITH ANTIBIOTICS AND UNDERWENT A FULL SYSTEM EXPLANT PROCEDURE. POSTOPERATIVELY, THE PATIENT WAS IN GOOD CONDITION. THE MEDICAL FACILITY RETAINED THE DEVICES, SO THEY WILL NOT BE RETURNED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE DEEP BRAIN STIMULATION (DBS) PATIENT SUFFERED A HEAD INJURY AT THE LEAD AND LEAD EXTENSION CONNECTION SITE, RESULTING IN EXPOSURE OF THE DEVICE AT THE CONNECTION POINT AND SUBSEQUENT INFECTION. A CULTURE WAS TAKEN, BUT THE RESULTS ARE UNKNOWN. THE PATIENT WAS TREATED WITH ANTIBIOTICS AND UNDERWENT A FULL SYSTEM EXPLANT PROCEDURE. POSTOPERATIVELY, THE PATIENT WAS IN GOOD CONDITION. THE MEDICAL FACILITY RETAINED THE DEVICES, SO THEY WILL NOT BE RETURNED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE DEEP BRAIN STIMULATION (DBS) PATIENT SUFFERED A HEAD INJURY AT THE LEAD AND LEAD EXTENSION CONNECTION SITE, RESULTING IN EXPOSURE OF THE DEVICE AT THE CONNECTION POINT AND SUBSEQUENT INFECTION. A CULTURE WAS TAKEN, BUT THE RESULTS ARE UNKNOWN. THE PATIENT WAS TREATED WITH ANTIBIOTICS AND UNDERWENT A FULL SYSTEM EXPLANT PROCEDURE. POSTOPERATIVELY, THE PATIENT WAS IN GOOD CONDITION. THE MEDICAL FACILITY RETAINED THE DEVICES, SO THEY WILL NOT BE RETURNED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE DEEP BRAIN STIMULATION (DBS) PATIENT SUFFERED A HEAD INJURY AT THE LEAD AND LEAD EXTENSION CONNECTION SITE, RESULTING IN EXPOSURE OF THE DEVICE AT THE CONNECTION POINT AND SUBSEQUENT INFECTION. A CULTURE WAS TAKEN, BUT THE RESULTS ARE UNKNOWN. THE PATIENT WAS TREATED WITH ANTIBIOTICS AND UNDERWENT A FULL SYSTEM EXPLANT PROCEDURE. POSTOPERATIVELY, THE PATIENT WAS IN GOOD CONDITION. THE MEDICAL FACILITY RETAINED THE DEVICES, SO THEY WILL NOT BE RETURNED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1884397 VERCISE GENUS? STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN SYMPTOMS NHL BOSTON SCIENTIFIC NEUROMODULATION CORPORATION DB-1416 206826 08714729985020

Patients

Seq Age Sex Outcome Treatment
1 62 YR Male Required Intervention