FDA Adverse Event Injury Summary report: N

AXONICS

MDR report key: 22136127 · Received June 3, 2025

Report

Report Number
2124215-2025-36378
Event Type
Injury
Date Received
June 3, 2025
Date of Event
May 1, 2025
Report Date
September 4, 2025
Manufacturer
AXONICS MODULATION TECHNOLOGIES, INC.
Product Code
EZW
UDI-DI
10810005340066
PMA / PMN Number
P180046
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

B3 DATE OF EVENT: UNKNOWN, USED THE FIRST DAY OF THE AWARE MONTH. ADDITIONAL PRODUCT CODE: QON. ADDITIONAL PREMARKET/510K: P190006.

Additional Manufacturer Narrative · 0

B3 DATE OF EVENT: UNKNOWN, USED THE FIRST DAY OF THE AWARE MONTH. ADDITIONAL PRODUCT CODE: QON. ADDITIONAL PREMARKET/510K: P190006.

Additional Manufacturer Narrative · 0

B3 DATE OF EVENT: UNKNOWN, USED THE FIRST DAY OF THE AWARE MONTH. ADDITIONAL PRODUCT CODE: QON. ADDITIONAL PREMARKET/510K: P190006.

Additional Manufacturer Narrative · 0

B3 DATE OF EVENT: UNKNOWN, USED THE FIRST DAY OF THE AWARE MONTH. ADDITIONAL PRODUCT CODE: QON. ADDITIONAL PREMARKET/510K: P190006.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT WITH THIS NEUROSTIMULATOR WAS EXPERIENCING A BUZZING SENSATION WHEN THE DEVICE WAS TURNED OFF. THE DEVICE WAS REMOVED PER PATIENT'S REQUEST. THERE WERE NO PATIENT COMPLICATIONS REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT WITH THIS NEUROSTIMULATOR WAS EXPERIENCING A BUZZING SENSATION WHEN THE DEVICE WAS TURNED OFF. THE DEVICE WAS REMOVED PER PATIENT'S REQUEST. THERE WERE NO PATIENT COMPLICATIONS REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT WITH THIS NEUROSTIMULATOR WAS EXPERIENCING A BUZZING SENSATION WHEN THE DEVICE WAS TURNED OFF. THE DEVICE WAS REMOVED PER PATIENT'S REQUEST. THERE WERE NO PATIENT COMPLICATIONS REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT WITH THIS NEUROSTIMULATOR WAS EXPERIENCING A BUZZING SENSATION WHEN THE DEVICE WAS TURNED OFF. THE DEVICE WAS REMOVED PER PATIENT'S REQUEST. THERE WERE NO PATIENT COMPLICATIONS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
358225 AXONICS STIMULATOR, ELECTRICAL, IMPLANTABLE, FOR INCONTINENCE EZW AXONICS MODULATION TECHNOLOGIES, INC. 1101 AX1G162391 10810005340066

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention| H LEAD - AL1T901666.| LEAD - AL1T901666.| LEAD - AL1T901666.