FDA Adverse Event Injury Summary report: N

AXONICS

MDR report key: 22136260 · Received June 3, 2025

Report

Report Number
2124215-2025-36377
Event Type
Injury
Date Received
June 3, 2025
Date of Event
May 12, 2025
Report Date
August 21, 2025
Manufacturer
AXONICS MODULATION TECHNOLOGIES, INC.
Product Code
EZW
UDI-DI
10810005340141
PMA / PMN Number
P180046
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL PRODUCT CODE: QON. ADDITIONAL PREMARKET/510K: P190006.

Additional Manufacturer Narrative · 0

ADDITIONAL PRODUCT CODE: QON. ADDITIONAL PREMARKET/510K: P190006.

Additional Manufacturer Narrative · 0

ADDITIONAL PRODUCT CODE: QON. ADDITIONAL PREMARKET/510K: P190006.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING AN EXTERNAL NEUROSTIMULATOR PROCEDURE, THE PATIENT HAD A REACTION TO THE MEDICATION GIVEN. IT WAS NOTED THAT THE PHYSICIAN COULD NOT FIND THE OPENING OF THE FORAMEN FOR THE LEAD DUE TO PATIENT ANATOMY. THE PATIENT HAD TWO 'SEIZURE LIKE' EPISODES AND THE PHYSICIAN DID NOT WANT TO PROCEED. THE CASE WAS ABORTED. THERE WERE NO FURTHER PATIENT COMPLICATIONS REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING AN EXTERNAL NEUROSTIMULATOR PROCEDURE, THE PATIENT HAD A REACTION TO THE MEDICATION GIVEN. IT WAS NOTED THAT THE PHYSICIAN COULD NOT FIND THE OPENING OF THE FORAMEN FOR THE LEAD DUE TO PATIENT ANATOMY. THE PATIENT HAD TWO 'SEIZURE LIKE' EPISODES AND THE PHYSICIAN DID NOT WANT TO PROCEED. THE CASE WAS ABORTED. THERE WERE NO FURTHER PATIENT COMPLICATIONS REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING AN EXTERNAL NEUROSTIMULATOR PROCEDURE, THE PATIENT HAD A REACTION TO THE MEDICATION GIVEN. IT WAS NOTED THAT THE PHYSICIAN COULD NOT FIND THE OPENING OF THE FORAMEN FOR THE LEAD DUE TO PATIENT ANATOMY. THE PATIENT HAD TWO 'SEIZURE LIKE' EPISODES AND THE PHYSICIAN DID NOT WANT TO PROCEED. THE CASE WAS ABORTED. THERE WERE NO FURTHER PATIENT COMPLICATIONS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
358248 AXONICS STIMULATOR, ELECTRICAL, IMPLANTABLE, FOR INCONTINENCE EZW AXONICS MODULATION TECHNOLOGIES, INC. 1201 AL1N143596 10810005340141

Patients

Seq Age Sex Outcome Treatment
1 40 YR Female Other PERCUTANEOUS EXTENSION 9009, (B)(6).| PERCUTANEOUS EXTENSION 9009, (B)(6).| PERCUTANEOUS EXTENSION 9009, (B)(6).| TRIAL STIMULATOR 1601, (B)(6).| TRIAL STIMULATOR 1601, (B)(6).| TRIAL STIMULATOR 1601, (B)(6).