FDA Adverse Event Injury Summary report: N

SPECTRA WAVEWRITER?

MDR report key: 22126922 · Received June 2, 2025

Report

Report Number
3006630150-2025-03869
Event Type
Injury
Date Received
June 2, 2025
Date of Event
May 8, 2025
Report Date
June 2, 2025
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
LGW
UDI-DI
08714729951254
PMA / PMN Number
P030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-PADDLE LEADS-MRI. UPN: M365SC8416700. MODEL: SC-8416-70. SERIAL: (B)(6). BATCH: 7070792/7057634. UDI: (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT UNDERWENT EXPLANT PROCEDURE DUE TO OTHER HARDWARE ADDITION. THE EXPLANTED DEVICE COMPONENTS WILL NOT BE RETURN. NO FURTHER INFORMATION HAS BEEN OBTAINED DESPITE GOOD FAITH EFFORTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
718416 SPECTRA WAVEWRITER? STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SC-1160 370072 08714729951254

Patients

Seq Age Sex Outcome Treatment
1 48 YR Female Required Intervention